Individual
EDWARD SUPINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3691 CLYDE MORRIS BLVD, PORT ORANGE, FL 32129-2317
(386) 675-4411
(866) 542-5859
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(386) 676-7125
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 80671
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259199500
—
FL
01
—
35630
BCBS
FL
Enumeration date
03/14/2006
Last updated
02/17/2026
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