Provider Demographics
NPI:1669002382
Name:DESARMES, EDZER (APRN)
Entity Type:Individual
Prefix:MR
First Name:EDZER
Middle Name:
Last Name:DESARMES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20423 STATE ROAD 7 STE F6
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6792
Mailing Address - Country:US
Mailing Address - Phone:561-995-6971
Mailing Address - Fax:561-569-8309
Practice Address - Street 1:5401 S CONGRESS AVE STE 201
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6637
Practice Address - Country:US
Practice Address - Phone:561-995-6971
Practice Address - Fax:561-569-8309
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily