Provider Demographics
NPI:1831117738
Name:IMPERIAL POINT EKG READERS INC
Entity Type:Organization
Organization Name:IMPERIAL POINT EKG READERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:PARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-421-1199
Mailing Address - Street 1:PO BOX 198474
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:FL
Mailing Address - Zip Code:30384-8474
Mailing Address - Country:US
Mailing Address - Phone:954-726-1808
Mailing Address - Fax:954-726-1820
Practice Address - Street 1:6401 N FEDERAL HWY
Practice Address - Street 2:EKG READERS PANEL
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1427
Practice Address - Country:US
Practice Address - Phone:954-776-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276891700Medicaid
FL276891700Medicaid