Provider Demographics
NPI:1801480587
Name:EDITA INCORPORATED
Entity type:Organization
Organization Name:EDITA INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:SCAVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-540-2457
Mailing Address - Street 1:1904 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2429
Mailing Address - Country:US
Mailing Address - Phone:813-540-2457
Mailing Address - Fax:
Practice Address - Street 1:7620 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-4510
Practice Address - Country:US
Practice Address - Phone:515-650-3005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty