Provider Demographics
NPI:1154867174
Name:EPIONE LLC
Entity Type:Organization
Organization Name:EPIONE LLC
Other - Org Name:PHYSIORENOVO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:NARCISO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MBA
Authorized Official - Phone:786-972-2643
Mailing Address - Street 1:8950 SW 74TH CT
Mailing Address - Street 2:SUITE 2201
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3171
Mailing Address - Country:US
Mailing Address - Phone:786-972-2643
Mailing Address - Fax:
Practice Address - Street 1:8950 SW 74TH CT
Practice Address - Street 2:SUITE 2201
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3171
Practice Address - Country:US
Practice Address - Phone:786-972-2643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11757208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty