Provider Demographics
NPI:1992029748
Name:EDELMAN, VICTORIA A (ARNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:EDELMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17385 SE 82ND PECAN TER
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2876
Mailing Address - Country:US
Mailing Address - Phone:610-453-8176
Mailing Address - Fax:
Practice Address - Street 1:212 S FLORIDA ST
Practice Address - Street 2:
Practice Address - City:BUSHNELL
Practice Address - State:FL
Practice Address - Zip Code:33513-6703
Practice Address - Country:US
Practice Address - Phone:352-793-2441
Practice Address - Fax:352-793-3282
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9331186363LA2200X
PASPO10755363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health