Healthcare Provider Details

I. General information

NPI: 1477846525
Provider Name (Legal Business Name): ASHIL J GOSALIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 SAND LAKE RD STE 127
ORLANDO FL
32819-8011
US

IV. Provider business mailing address

7300 SAND LAKE RD STE 127
ORLANDO FL
32819-8011
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-9025
  • Fax: 321-842-3651
Mailing address:
  • Phone: 321-841-9025
  • Fax: 321-842-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLP02278
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME119259
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: