Provider Demographics
NPI:1700860681
Name:EPIRAD INC.,
Entity Type:Organization
Organization Name:EPIRAD INC.,
Other - Org Name:FLORIDA SKIN CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:HARLAN
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:772-463-2346
Mailing Address - Street 1:4400 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-7620
Mailing Address - Country:US
Mailing Address - Phone:281-337-3423
Mailing Address - Fax:281-337-2611
Practice Address - Street 1:400 SE OSCEOLA ST
Practice Address - Street 2:STE. 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2504
Practice Address - Country:US
Practice Address - Phone:772-463-2346
Practice Address - Fax:772-463-2310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5924Medicare ID - Type Unspecified