Samuel M Edwards M D P a

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0066309 Issued in FL

Legal business name

SAMUEL M EDWARDS M D P A

Practice address

750 W Plymouth Ave
Deland, FL 32720-3282

Phone

(386) 736-7244

Fax

(386) 736-8538

NPI assigned

Oct 26, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lynette A Tarnowski

Title

Office Manager

Phone

(386) 736-7244

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel M Edwards, M. D.

  • Specialist
  • Deland, FL
  • NPI 1386706000
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1023394707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203282",
            "telephone_number": "386-736-7244",
            "fax_number": "386-736-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203282",
            "telephone_number": "386-736-7244",
            "fax_number": "386-736-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL M EDWARDS M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "TARNOWSKI",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-736-7244",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0066309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272821400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Saltzman, Tanis, Pittel, Levin and Jacobson, LLC
• Gerald Salvatico, CRNA
• Leonardo Samalot, D.C.
• Jessica Sambucharan
• Henry N Samsoe, PA-C
• Yamelys Sanabria Mendez, DC
• Diane Sanchez-Cintron, OTR/L
• Eileen Sanchez, LMHC
• Sandcastle Care II LLC
• Lauren Sands

• Internal Medicine Physician in Deland, FL
• Providers in Deland, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.