Individual
LEETORIA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
10740 PALM RIVER RD, TAMPA, FL 33619-4573
(813) 660-6000
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9220776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001665400
—
FL
01
—
Y08FE
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/28/2009
Last updated
07/19/2021
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