Provider Demographics
NPI:1992863690
Name:EDM INVESTMENTS, INC
Entity Type:Organization
Organization Name:EDM INVESTMENTS, INC
Other - Org Name:ACTIVE MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-331-3303
Mailing Address - Street 1:976 FLORIDA CENTRAL PKWY
Mailing Address - Street 2:SUITE 112 A
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-7504
Mailing Address - Country:US
Mailing Address - Phone:407-331-3303
Mailing Address - Fax:407-331-5484
Practice Address - Street 1:976 FLORIDA CENTRAL PKWY
Practice Address - Street 2:SUITE 112 A
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7504
Practice Address - Country:US
Practice Address - Phone:407-331-3303
Practice Address - Fax:407-331-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1341332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR9272OtherBCBS OF FLORIDA
FL022684000Medicaid
FL022684000Medicaid