Provider Demographics
NPI:1225441348
Name:JOSEPH, EDLYNE (ARNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:EDLYNE
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 N UNIVERSITY DR STE 612
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-4510
Mailing Address - Country:US
Mailing Address - Phone:954-480-3072
Mailing Address - Fax:806-363-5131
Practice Address - Street 1:14201 W SUNRISE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3207
Practice Address - Country:US
Practice Address - Phone:954-480-3072
Practice Address - Fax:806-363-5131
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9278398363LF0000X, 363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care