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General NPI Number Information
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NPI Number | 1174834576
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Entity Type | Individual
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Provider Name | EPHRAIM E PARENT MD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224
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Country | US
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Telephone | 904-953-2000
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Fax | 314-747-4189
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Provider Business Mailing Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1865
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Country | US
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Telephone | 904-953-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 2013009624
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | ME137212
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License Number State | FL
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