Healthcare Provider Details
I. General information
NPI: 1588811533
Provider Name (Legal Business Name): ECG CONSULTANTS OF BETHESDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/21/2008
Last Update Date: 07/24/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2580 S SEACREST BLVD
BOYNTON BEACH FL
33435-6789
US
IV. Provider business mailing address
PO BOX 919331
ORLANDO FL
32891-9331
US
V. Phone/Fax
- Phone: 561-369-7865
- Fax: 561-369-7169
- Phone: 954-726-1808
- Fax: 954-726-1820
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAMEER
VERMA
Title or Position: MGRM
Credential: MD
Phone: 561-369-7865