Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Micah Boaz Obadiah Edwin, MD

Individual provider General Practice Physician · NPI 1033430327

Dr. Micah Boaz Obadiah Edwin, MD is a General Practice in Lauderdale Lakes, Florida. Qualified in 2007, 19 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Florida, North Carolina and New York.

Years since qualifying
19
Licensed in
FL, NC, NY
In the registry since
2010
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4850 W Oakland Park Blvd Ste 224
Lauderdale Lakes, FL 33313-7261
Phone: (786) 214-2001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ME143503 (FL)
General Practice Physician Taxonomy 208D00000X · Licence 261987 (NY)
General Practice Physician Taxonomy 208D00000X · Licence 2010-01073 (NC)

Record details

NPI number1033430327
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 21, 2010
Last updated in NPPESMarch 8, 2026
Certification dateMarch 8, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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