Healthcare Provider Details

I. General information

NPI: 1922931609
Provider Name (Legal Business Name): WELLINGTON DIGETIVE INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 MEDICAL PARK BLVD STE 405
WELLINGTON FL
33414-3183
US

IV. Provider business mailing address

1447 MEDICAL PARK BLVD STE 405
WELLINGTON FL
33414-3183
US

V. Phone/Fax

Practice location:
  • Phone: 561-767-8342
  • Fax: 866-622-3008
Mailing address:
  • Phone: 561-767-8342
  • Fax: 866-622-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SRINIVAS KAZA
Title or Position: OWNER PHYSICIAN
Credential: MD
Phone: 561-767-8342