Individual
EDMOND NJUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9330 STATE ROAD 54, TRINITY, FL 34655-1808
(727) 834-4000
Mailing address
10709 DEERBERRY DR, LAND O LAKES, FL 34638-6893
(701) 610-0726
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME171698
FL
Other
Enumeration date
04/02/2022
Last updated
10/24/2025
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