Healthcare Provider Details
I. General information
NPI: 1376220145
Provider Name (Legal Business Name): GCGA PHYSICIANS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/03/2023
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2925 VERNON PL STE 100
CINCINNATI OH
45219-2425
US
IV. Provider business mailing address
9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US
V. Phone/Fax
- Phone: 513-751-6667
- Fax: 513-872-4553
- Phone: 786-530-3820
- Fax: 305-675-3378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
OLIVER
Title or Position: CEO
Credential: CEO
Phone: 786-530-3820