Individual
ELVIN LEPHIEW DENNINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 W HIBISCUS BLVD, STE 215, MELBOURNE, FL 32901-2620
(321) 837-3820
Mailing address
1775 W HIBISCUS BLVD, STE 215, MELBOURNE, FL 32901-2620
(321) 837-3820
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
E-4834
AR
2085R0202X
Diagnostic Radiology Physician
Primary
ME117693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161774001
—
AR
Enumeration date
07/28/2006
Last updated
11/18/2016
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