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General NPI Number Information
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NPI Number | 1578810743
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Entity Type | Organization
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Legal Business Name | VENTURE GASTROENTEROLOGY LLC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 16855 NE 2ND AVE SUITE 300
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-1744
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Country | US
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Telephone | 305-654-4488
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Fax | 305-654-8157
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Provider Business Mailing Address
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Address Line | 2523 REGATTA AVE
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4234
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Country | US
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Telephone | 305-654-4488
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Fax | 305-654-8157
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW E NULLMAN
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Credential | MD
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Telephone | 305-534-4404
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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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