EDWARD VIDAL


Address: 2331 W Carson Rd, Phoenix, AZ 85041-6408
Phone: 6025162494

EDWARD VIDAL (NPI# 1386123305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386123305
Entity Type Individual
Full Name EDWARD VIDAL
Credential FNP
Practice Address 2331 W Carson Rd
Phoenix
AZ 85041-6408
Practice Telephone 6025162494
Enumeration Date 2018-08-09
Last Update Date 2018-11-21
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP11639 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Providers EDWARD VIDAL

NPI Name Taxonomy Address Enumeration
1831683325 Edward P Vidal Case Manager/Care Coordinator 3195 M St, Merced, CA 95348-2406 2018-06-18

Office Location

Street Address 2331 W CARSON RD
City PHOENIX
State AZ
Zip Code 85041-6408

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City PHOENIX
Zip Code 85041

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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