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BRUCE J EDSON MD PA NPI 1922346030


NPI Information

NPI: 1922346030
Provider Name: BRUCE J EDSON MD PA

Former Legal Business Name: BRUCE J EDSON MD

Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
16554 N DALE MABRY HWY
TAMPA, FL
ZIP 33618
Phone: (813) 968-7188
Get Directions

BRUCE J EDSON MD PA is a prescribing (medical) psychologist in Tampa, FL. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. BRUCE J EDSON MD PA NPI is 1922346030. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Bruce J Edson Md.

The provider's business location address is:

16554 N DALE MABRY HWY
TAMPA, FL
ZIP 33618-325
Phone: (813) 968-7188
Fax: (813) 715-9802

The provider's authorized official is Cindi Germond .
The authorized official title is Administrative Assistant and has the following contact phone number (813) 715-9802.

The enumeration date for this NPI number is 1/24/2013 and was last updated on 1/24/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP0016XPsychologistPrescribing (Medical)ME0055695FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E89932MEDICARE UPINFLORIDA
212668MEDICARE PINFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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