Healthcare Provider Details

I. General information

NPI: 1912936105
Provider Name (Legal Business Name): PRO-ECHO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ARTHUR GODFREY ROAD SUITE 201
MIAMI BEACH FL
33140-3627
US

IV. Provider business mailing address

PO BOX 546436
SURFSIDE FL
33154-0436
US

V. Phone/Fax

Practice location:
  • Phone: 305-532-7460
  • Fax: 305-532-7648
Mailing address:
  • Phone: 305-532-7460
  • Fax: 305-532-7648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License NumberHCC4839
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberHCC4839
License Number StateFL

VIII. Authorized Official

Name: DR. DARYL J EBER
Title or Position: OWNER / MEDICAL DIRECTOR
Credential: M.D.
Phone: 305-532-7460