Provider Demographics
NPI:1417940206
Name:MERRILL H EPSTEIN MD PA
Entity Type:Organization
Organization Name:MERRILL H EPSTEIN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:H
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-368-3388
Mailing Address - Street 1:4800 N FEDERAL HWY
Mailing Address - Street 2:SUITE A205
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5176
Mailing Address - Country:US
Mailing Address - Phone:561-368-3388
Mailing Address - Fax:561-620-3090
Practice Address - Street 1:4800 N FEDERAL HWY
Practice Address - Street 2:SUITE A205
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5176
Practice Address - Country:US
Practice Address - Phone:561-368-3388
Practice Address - Fax:561-620-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00345832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63410Medicare UPIN
FLK3739Medicare PIN
FLCK2889Medicare PIN