Individual provider Active NPI

Christiania Viola Edstrom

  • Physical Medicine & Rehabilitation Physician
  • Pembroke Pines, FL
National Provider Identifier
1558065417
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME181303 Issued in FL
Practice address
703 N Flamingo Rd
Pembroke Pines, FL 33028-1006
Phone
(954) 518-5936
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME181303 FL Primary

Addresses

Primary practice location

703 N Flamingo Rd
Pembroke Pines, FL 33028-1006

Mailing address

145 Hibiscus PL
River Ridge, LA 70123-2505
Phone (612) 859-9858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230703001862 FL Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 9739548140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1558065417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HIBISCUS PL",
            "city": "RIVER RIDGE",
            "state": "LA",
            "postal_code": "701232505",
            "telephone_number": "612-859-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281006",
            "telephone_number": "954-518-5936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "CHRISTIANIA",
        "middle_name": "VIOLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME181303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.