Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | FL |
NPI | 1477878965 |
---|---|
Provider Name | Baldwin Edwards |
First Address | Miami, FL 33162-3543 |
Second Address | Lauderdale Lakes, FL 33319-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 29/03/2010 |