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General NPI Number Information
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NPI Number | 1104257526
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Entity Type | Organization
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Legal Business Name | FLORIDA DIGESTIVE HEALTH SPECIALISTS LLP
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 2061 ENGLEWOOD RD SUITE 4
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City | ENGLEWOOD
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State | FL
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Zip | 34223-1749
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Country | US
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Telephone | 941-473-8881
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Fax | 941-475-0801
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Provider Business Mailing Address
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Address Line | 2061 ENGLEWOOD RD SUITE 4
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City | ENGLEWOOD
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State | FL
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Zip | 34223-1749
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Country | US
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Telephone | 941-473-8881
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Fax | 941-475-0801
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Authorized Official
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Title or Position | PARTNER
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Name | VITO ANTHONY DITOMASO
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Credential | MD
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Telephone | 941-473-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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