Ekos Palm Bay, PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

EKOS PALM BAY, PLLC

Practice address

195 Malabar Rd NW Ste a-2
Palm Bay, FL 32907-2962

Phone

(813) 340-0116

NPI assigned

Aug 23, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Giovanna Dejesus

Title

Operations MGR

Phone

(561) 899-7115

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1588448211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8794 BOYNTON BEACH BLVD STE 218",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724469",
            "telephone_number": "561-899-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MALABAR RD NW STE A-2",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072962",
            "telephone_number": "813-340-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EKOS PALM BAY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "GIOVANNA",
        "authorized_official_title_or_position": "OPERATIONS MGR",
        "authorized_official_telephone_number": "561-899-7115"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.