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General NPI Number Information
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NPI Number | 1871704262
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Entity Type | Organization
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Legal Business Name | AMELIA ISLAND EKG ASSOCIATES, PA
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 1250 S 18TH ST
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-1902
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Country | US
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Telephone | 904-321-3500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5708
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City | JACKSONVILLE
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State | FL
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Zip | 32247-5708
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Country | US
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Telephone | 904-396-2342
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Fax |
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | MORRIS MORAN
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Credential |
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Telephone | 904-396-2342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number |
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License Number State |
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