Doctor Name: | ADRIANA EDEN |
NPI Number: | 1124015573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | WHNP |
License Number: | 2052002 |
Business Practice Address: | 1381 S Patrick Dr 45th Medical Group Patrick Afb, FL - 329253606 |
Business Phone Number: | 3214948191 |
Business Fax Number: | 3214941874 |
Mailing Address: | 1025 Laughing Gull Dr, SATELLITE BEACH |
State: | FL |
Postal Code: | 329375539 |
Phone Number: | 3216225286 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2005 |
NPI Last Update Date: | 03/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 2052002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |