Healthcare Provider Details

I. General information

NPI: 1942277181
Provider Name (Legal Business Name): DIGESTIVE DISEASE AND CANCER INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 09/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34653 US 19 N
PALM HARBOR FL
34684-2152
US

IV. Provider business mailing address

34653 US 19 N
PALM HARBOR FL
34684
US

V. Phone/Fax

Practice location:
  • Phone: 727-771-6135
  • Fax: 727-771-2514
Mailing address:
  • Phone: 727-771-6135
  • Fax: 727-771-2514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME72984
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME72929
License Number StateFL

VIII. Authorized Official

Name: DR. ANOOP GOYAL
Title or Position: OWNER
Credential: M.D.
Phone: 727-771-6135