Healthcare Provider Details

I. General information

NPI: 1487767133
Provider Name (Legal Business Name): GASTRO HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9408 SW 87TH AVE STE 200
MIAMI FL
33176-2416
US

IV. Provider business mailing address

9408 SW 87TH AVE STE 200
MIAMI FL
33176-2416
US

V. Phone/Fax

Practice location:
  • Phone: 305-913-0666
  • Fax: 305-913-0663
Mailing address:
  • Phone: 305-913-0666
  • Fax: 305-913-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME23493
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME29038
License Number StateFL

VIII. Authorized Official

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