Dr. Micah Boaz Edwin
General Practice Physician
4850 W Oakland Park Blvd Ste 224
Lauderdale Lakes
, Florida 33313-7261
Dr. Micah Boaz Edwin
General Practice Physician
4850 W Oakland Park Blvd Ste 224
Lauderdale Lakes
, Florida 33313-7261
(526) 305-2802
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Micah Boaz Edwin
- Po Box 4067
- Ft Lauderdale, FL
- Zip : 33338-4067
- Phone : (526) 305-2802
Second Address
- Dr. Micah Boaz Edwin
- 4850 W Oakland Park Blvd Ste 224
- Lauderdale Lakes, FL
- Zip : 33313-7261
- Phone : (786) 214-2001
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Is Dr. Micah Boaz Edwin a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208D00000X | General Practice Physician | 2010-01073 | NC |
| N | 208D00000X | General Practice Physician | 261987 | NY |
| Y | 208D00000X | General Practice Physician | ME143503 | FL |
National Provider Identifier
| NPI | 1033430327 |
|---|---|
| Provider Name | Dr. Micah Boaz Edwin |
| First Address | Ft Lauderdale, FL 33338-4067 |
| Second Address | Lauderdale Lakes, FL 33313-7261 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/06/2010 |
| Last Update Date | 08/04/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.