Provider Demographics
NPI:1033116744
Name:MILCARSKY, EDWARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:MILCARSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9671
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-9671
Mailing Address - Country:US
Mailing Address - Phone:386-427-4868
Mailing Address - Fax:386-427-6350
Practice Address - Street 1:239 N RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1734
Practice Address - Country:US
Practice Address - Phone:386-427-4868
Practice Address - Fax:386-427-6350
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2013-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0058714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14366OtherBCBS
FL007625000Medicaid
FL1033116744OtherTRICARE
FL007625000Medicaid
FL1033116744OtherTRICARE