Antavian Edison

NPI #1063074292 in Fort Myers, Florida

Provider Information

NPI Number: 1063074292
Entity Type: Individual
Name: Antavian Edison
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Enumeration Date: Jul 9, 2019
Last Updated: Jul 9, 2019

Practice Location

Address: 2789 ORTIZ AVE
City: Fort Myers
State: Florida
ZIP Code: 33905-7806
Phone: (239) 275-3222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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