Healthcare Provider Details

I. General information

NPI: 1215375332
Provider Name (Legal Business Name): ELECTROPHYSIOLOGY CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2013
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3370 BURNS RD SUITE 105
PALM BEACH GARDENS FL
33410-4327
US

IV. Provider business mailing address

3370 BURNS RD SUITE 105
PALM BEACH GARDENS FL
33410-4327
US

V. Phone/Fax

Practice location:
  • Phone: 561-630-8570
  • Fax:
Mailing address:
  • Phone: 561-630-8570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number9270237
License Number StateFL

VIII. Authorized Official

Name: SIMIE PLATT
Title or Position: ADMIN SIGNED NAME
Credential: M.D.
Phone: 561-630-8570