Provider Demographics
NPI:1407430788
Name:EPL INNOVATIVE SOLUTIONS
Entity Type:Organization
Organization Name:EPL INNOVATIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO,CCO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DONOHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-322-2375
Mailing Address - Street 1:1903 NW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1315
Mailing Address - Country:US
Mailing Address - Phone:352-322-2375
Mailing Address - Fax:
Practice Address - Street 1:1903 NW 45TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1315
Practice Address - Country:US
Practice Address - Phone:352-322-2375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No251X00000XAgenciesSupports Brokerage
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, FederalGroup - Multi-Specialty
No305S00000XManaged Care OrganizationsPoint of Service
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)