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General NPI Number Information
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NPI Number | 1386659761
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Entity Type | Organization
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Legal Business Name | E.P. IMAGING INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1965 CANOPY DR
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City | MELBOURNE
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State | FL
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Zip | 32935-3811
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Country | US
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Telephone | 321-652-6522
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Fax | 321-574-5059
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Provider Business Mailing Address
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Address Line | 1965 CANOPY DR
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City | MELBOURNE
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State | FL
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Zip | 32935-3811
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Country | US
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Telephone | 321-652-6522
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Fax | 321-574-5059
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Authorized Official
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Title or Position | CARDIOVASCULAR SONOGRAPHER
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Name | MR. ERIC PASCUS SMITH
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Credential |
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Telephone | 321-536-1863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number |
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License Number State | FL
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