Healthcare Provider Details

I. General information

NPI: 1033165865
Provider Name (Legal Business Name): DAVID SAMUEL EPSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 W HIBISCUS BLVD STE 215
MELBOURNE FL
32901-2620
US

IV. Provider business mailing address

1775 W HIBISCUS BLVD STE 215
MELBOURNE FL
32901-2620
US

V. Phone/Fax

Practice location:
  • Phone: 321-837-3820
  • Fax:
Mailing address:
  • Phone: 321-837-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC1-0008029
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME105071
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME105071
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: