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General NPI Number Information
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NPI Number | 1336504125
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Entity Type | Organization
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Legal Business Name | GI MEDICAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 2626 CARE DR STE 101
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4495
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Country | US
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Telephone | 850-733-6560
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Fax | 850-733-6563
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Provider Business Mailing Address
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Address Line | 2626 CARE DR STE 101
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4489
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KISHOR MUNIYAPPA
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Credential | M.D.
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Telephone | 804-647-3751
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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 | ME120003
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License Number State | FL
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