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

Michael Edmiston, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1790324549

Michael Edmiston, PHYSICIANASSISTANT is a Physician Assistant in Orlando, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2019
Specialties on file
2

Practice location Address checks out

1222 S Orange Ave
Orlando, FL 32806-1215
Phone: (321) 841-6444
Fax: (407) 445-3515
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2415 N Orange Ave Ste 302, Orlando, FL 32804-5505 — (407) 303-7250

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9113231 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA9113231 (FL)

Record details

NPI number1790324549
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedDecember 26, 2019
Last updated in NPPESFebruary 13, 2024
Certification dateFebruary 13, 2024
Mailing address1222 S Orange Ave, Orlando, FL 32806-1215

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