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Provider Information for 1821011974

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. JIMMY EDMOND MD

Gender: MALE

Individual NPI: 1821011974

Calendar   Last Updated:  2021-05-24
  Certification Date:  2021-05-24

Details

Name Value
NPI 1821011974
Enumeration Date 2006-07-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 3189
SPRING HILL, FL 34611-3189
United States

Phone: 352-666-0790 | Fax: 352-666-0903
View Map External Link
Primary Practice Address 7539 SPRING HILL DR
SPRING HILL, FL 34606-4350
United States

Phone: 352-666-0790 | Fax: 352-666-0903
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME81127
No 207RG0300X - Internal Medicine Geriatric Medicine FL ME81127