Healthcare Provider Details
I. General information
NPI: 1437857513
Provider Name (Legal Business Name): GASTRO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2023
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7765 SW 87TH AVE STE 212
MIAMI FL
33173-2586
US
IV. Provider business mailing address
7765 SW 87TH AVE STE 212
MIAMI FL
33173-2586
US
V. Phone/Fax
- Phone: 305-596-3080
- Fax: 305-596-3073
- Phone: 305-596-3080
- Fax: 305-596-3073
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
OLIVER
Title or Position: CEO
Credential: CEO
Phone: 786-530-3820