Healthcare Provider Details

I. General information

NPI: 1740978469
Provider Name (Legal Business Name): GASTRO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7152 COCA SABAL LN # 75
FORT MYERS FL
33908-4263
US

IV. Provider business mailing address

7152 COCA SABAL LN # 75
FORT MYERS FL
33908-4263
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-9939
  • Fax: 239-931-5060
Mailing address:
  • Phone: 239-939-9939
  • Fax: 239-931-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALAN OLIVER
Title or Position: CEO
Credential:
Phone: 786-530-3820