Healthcare Provider Details

I. General information

NPI: 1801540117
Provider Name (Legal Business Name): GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2022
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13137 SORRENTO RD
PENSACOLA FL
32507-8777
US

IV. Provider business mailing address

9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-0020
  • Fax: 850-436-4570
Mailing address:
  • Phone: 305-468-4185
  • 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: LAWRRENCE G. FRENI
Title or Position: CFO
Credential:
Phone: 305-458-7715