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General NPI Number Information
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NPI Number | 1346438959
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CENTER OF SOUTH FLORIDA PA
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 5130 LINTON BLVD #111
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6596
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Country | US
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Telephone | 561-498-5570
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Fax | 561-498-3714
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Provider Business Mailing Address
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Address Line | 5130 LINTON BLVD #B5
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City | DELRAY BEACH
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State | FL
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Zip | 33484-6596
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Country | US
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Telephone | 561-498-5570
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Fax | 561-498-3714
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRADLEY A TOWBIN
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Credential | MD
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Telephone | 561-498-5570
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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 | ME65968
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License Number State | FL
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