Provider Demographics
NPI:1447413620
Name:EPITROPOULOS, MICHAEL (DC, PHD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:EPITROPOULOS
Suffix:
Gender:M
Credentials:DC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 NORTH CLYDE MORRIS BLVD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117
Mailing Address - Country:US
Mailing Address - Phone:386-274-2520
Mailing Address - Fax:386-274-2521
Practice Address - Street 1:1663 N CLYDE MORRIS BLVD
Practice Address - Street 2:SUIT #2
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5500
Practice Address - Country:US
Practice Address - Phone:386-274-2520
Practice Address - Fax:386-274-2521
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89058OtherBCBS
FL89058OtherBCBS