Provider Demographics
NPI:1093977902
Name:EDWARDS, MELISSA (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-217-5700
Mailing Address - Fax:954-217-5704
Practice Address - Street 1:2300 N COMMERCE PKWY STE 103
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3255
Practice Address - Country:US
Practice Address - Phone:954-217-5700
Practice Address - Fax:954-217-5704
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30007923363LF0000X
FL9275574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily