Healthcare Provider Details

I. General information

NPI: 1922921857
Provider Name (Legal Business Name): GASTRO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 CONCOURSE PKWY S STE 200
MAITLAND FL
32751-8101
US

IV. Provider business mailing address

9200 S DADELAND BLVD STE 800
MIAMI FL
33156-2758
US

V. Phone/Fax

Practice location:
  • Phone: 407-644-4014
  • Fax: 407-644-5270
Mailing address:
  • Phone: 786-530-3820
  • Fax:

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