BRUCE J EDSON MD PA - NPI 1922346030 - Psychologist in Tampa, FL

Q: What is Bruce J Edson MD PA's NPI number?

The NPI number for Bruce J Edson MD PA is 1922346030. It was assigned to this organization in the NPPES registry on January 24, 2013. The provider was formerly known as Bruce J Edson MD.

Q: What is Bruce J Edson MD PA's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

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About Bruce J Edson Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRUCE J EDSON MD PA (NPI 1922346030), doing business as Bruce J Edson Md, is a healthcare organization registered as a prescribing (medical) in Tampa, Florida and active in the NPI registry since January 2013. The organization lists Cindi Germond, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1922346030

Entity TypeOrganization

Primary Taxonomy103TP0016X

Legal Business NameBRUCE J EDSON MD PA

Location Address16554 N DALE MABRY HWYTampa, FL 33618-1325

Mailing Address16554 N Dale Mabry HwyTampa, FL 33618-1325 · (813) 968-7188 · Fax (813) 715-9802

Phone(813) 968-7188

Fax(813) 715-9802

Organization SubpartNo

Authorized OfficialCindi GermondAdministrative Assistant · (813) 715-9802

Enumeration DateJanuary 24, 2013

✔ NPI 1922346030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Prescribing (Medical)Behavioral Health & Social Service Providers

Taxonomy Code103TP0016X

License✔ Licensed in FL · ME0055695

Definition

A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

16554 N DALE MABRY HWY, Tampa, FL 33618

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Other Names 1

Former Legal Business NameBruce J Edson Md

Other Identifiers 2

Medicare UPINE89932FL

Medicare PIN12668FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALEX KAWLICHE LMHC

Counselor (Mental Health)