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General NPI Number Information
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NPI Number | 1437664117
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Entity Type | Organization
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Legal Business Name | DR LE ADVANCED GASTROENTEROLOGY
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 8425 BALM ST
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City | WEEKI WACHEE
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State | FL
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Zip | 34607-4419
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Country | US
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Telephone | 352-688-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 8425 BALM ST
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City | WEEKI WACHEE
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State | FL
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Zip | 34607-4419
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Country | US
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Telephone | 352-688-2700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRUCE GIANG LE
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Credential | DO
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Telephone | 352-688-2700
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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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