| Stacy L. Edwards, D.O. | |
|
2623 Mccormick Dr Ste 101 Clearwater FL 33759-1046 | |
| (727) 564-9336 | |
| (727) 223-3228 |
| Full Name | Stacy L. Edwards, D.O. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2623 Mccormick Dr Ste 101, Clearwater, Florida |
| Authorized Official Name and Position | Stacy L Edwards (PHYSICIAN) |
| Authorized Official Contact | 7274106655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy L. Edwards, D.O. 1022 Main St Suite M Dunedin FL 34698-5225 Ph: (727) 733-7922 | Stacy L. Edwards, D.O. 2623 Mccormick Dr Ste 101 Clearwater FL 33759-1046 Ph: (727) 564-9336 |
| NPI Number | 1730105172 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 3476557216 |
|---|---|
| Medicare Enrollment ID | O20060908000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730105172 | NPI | - | NPPES |
| 257297 | Other | FL | AVMED |
| 5580758 | Other | FL | AETNA |
| 123421 | Other | FL | HUMANA |
| 20886 | Other | FL | BCBS |
| 0161979008 | Other | FL | CIGNA |
| 1057441 | Other | FL | AETNA |
| 1320 | Other | FL | BAYCARE |
| 0001713 | Other | FL | UHC |
| 0412595 | Other | FL | UHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS7714 (Florida) | Primary |
| Provider Name | Stacy L Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700812690 PECOS PAC ID: 6204862931 Enrollment ID: I20050713000764 |
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