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NPI Code Detail

MEDICARE: GASTROENTEROLOGY CONSULTANTS, P.A.

MEDICARE: GASTROENTEROLOGY CONSULTANTS, P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CL6881OTHERFLRAILROAD MEDICARE

General Provider Information

NPI Number : 1982692943
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTROENTEROLOGY CONSULTANTS, P.A.
Provider Business Mailing Address
First Line : 300 CLYDE MORRIS BLVD
Second Line : SUITE A
City : ORMOND BEACH
State : FL
Zip : 32174-5956
Country : US
Telephone Number : 386-677-0531
Fax Number : 386-673-0604
Provider Business Practice Location Address
First Line : 300 CLYDE MORRIS BLVD
Second Line : SUITE A
City : ORMOND BEACH
State : FL
Zip : 32174-5956
Country : US
Telephone Number : 386-677-0531
Fax Number : 386-673-0604
Authorized Official
Title or Position : BILLING MANAGER
Name : LINDA EGGERTON
Credential :
Telephone Number : 386-677-0531
Provider Enumeration Date : 10/12/2005
Last Update Date : 08/22/2020

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Directions to “GASTROENTEROLOGY CONSULTANTS, P.A. ” Practice Location

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