Provider Demographics
NPI:1073768867
Name:EPIC SERVICES, LLC
Entity Type:Organization
Organization Name:EPIC SERVICES, LLC
Other - Org Name:RELAX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-961-7306
Mailing Address - Street 1:10025 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4409
Mailing Address - Country:US
Mailing Address - Phone:813-961-7306
Mailing Address - Fax:
Practice Address - Street 1:10025 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4409
Practice Address - Country:US
Practice Address - Phone:813-961-7306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM21223174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty