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General NPI Number Information
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NPI Number | 1851912943
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Entity Type | Organization
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Legal Business Name | EP CRITICAL CARE LLC
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 4725 N FEDERAL HWY
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4603
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Country | US
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Telephone | 954-771-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24847
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City | JACKSONVILLE
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State | FL
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Zip | 32241-4847
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK CAPUTO
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Credential | MD
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Telephone | 918-527-7024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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