Healthcare Provider Details

I. General information

NPI: 1891474185
Provider Name (Legal Business Name): GASTRO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 SHERIDAN ST STE F
HOLLYWOOD FL
33021-3416
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-8400
  • Fax: 954-961-8401
Mailing address:
  • Phone: 305-468-4185
  • Fax: 305-675-3378

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