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General NPI Number Information
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NPI Number | 1134325921
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOC PA
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 5301 N DIXIE HWY STE 202
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3403
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Country | US
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Telephone | 954-771-9920
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Fax | 954-771-9922
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Provider Business Mailing Address
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Address Line | 5301 N DIXIE HWY STE 202
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3403
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Country | US
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Telephone | 954-771-9920
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Fax | 954-771-9922
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. STEPHANIE S EMERSON
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Credential |
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Telephone | 954-771-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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