Provider Demographics
NPI:1033165865
Name:EPSTEIN, DAVID SAMUEL (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SAMUEL
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 W HIBISCUS BLVD
Mailing Address - Street 2:STE 215
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2620
Mailing Address - Country:US
Mailing Address - Phone:321-837-3820
Mailing Address - Fax:
Practice Address - Street 1:1775 W HIBISCUS BLVD
Practice Address - Street 2:STE 215
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2620
Practice Address - Country:US
Practice Address - Phone:321-837-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00080292085R0202X
FLME1050712085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00340067OtherRAILROAD MEDICARE #
FL001499300Medicaid
DE1000039991Medicaid
DE019767X70Medicare PIN
I58345Medicare UPIN
FL001499300Medicaid
DE1000039991Medicaid