Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Christian Jerrard Edmonds

Individual provider Developmental Disabilities Clinic/Center · NPI 1063167658

Christian Jerrard Edmonds is a Developmental Disabilities Clinic/Center in Seffner, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2022
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Practice location Address checks out

11721 Mango Groves Blvd
Seffner, FL 33584-6405
Phone: (813) 500-8919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Disabilities Clinic/Center (primary) Taxonomy 261QD1600X · Licence 112858700 (FL)

Record details

NPI number1063167658
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 13, 2022
Last updated in NPPESFebruary 13, 2022
Certification dateFebruary 13, 2022
Mailing address11721 Mango Groves Blvd, Seffner, FL 33584-6405

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