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General NPI Number Information
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NPI Number | 1912936105
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Entity Type | Organization
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Legal Business Name | PRO-ECHO INC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 300 ARTHUR GODFREY ROAD SUITE 201
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3627
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Country | US
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Telephone | 305-532-7460
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Fax | 305-532-7648
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Provider Business Mailing Address
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Address Line | PO BOX 546436
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City | SURFSIDE
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State | FL
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Zip | 33154-0436
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Country | US
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Telephone | 305-532-7460
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Fax | 305-532-7648
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Authorized Official
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Title or Position | OWNER / MEDICAL DIRECTOR
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Name | DR. DARYL J EBER
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Credential | M.D.
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Telephone | 305-532-7460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | HCC4839
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC4839
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License Number State | FL
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