Provider Demographics
NPI:1306646328
Name:EKOS POINCIANA, PLLC
Entity type:Organization
Organization Name:EKOS POINCIANA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GIOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-340-0116
Mailing Address - Street 1:8794 BOYNTON BEACH BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4469
Mailing Address - Country:US
Mailing Address - Phone:561-899-7115
Mailing Address - Fax:
Practice Address - Street 1:4748 MARIGOLD AVE
Practice Address - Street 2:
Practice Address - City:POINCIANA
Practice Address - State:FL
Practice Address - Zip Code:34758-4380
Practice Address - Country:US
Practice Address - Phone:407-449-2630
Practice Address - Fax:407-449-2631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental