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General NPI Number Information
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NPI Number | 1700382736
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOCIATES OF FLORIDA LLC
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 5401 S CONGRESS AVE STE 211
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City | ATLANTIS
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State | FL
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Zip | 33462-6637
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Country | US
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Telephone | 561-964-8221
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Fax | 561-964-7393
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Provider Business Mailing Address
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Address Line | 5401 S CONGRESS AVE STE 211
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City | ATLANTIS
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State | FL
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Zip | 33462-6637
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Country | US
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Telephone | 561-964-8221
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Fax | 561-964-7393
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | KRISTINA KAY LOWERY
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Credential |
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Telephone | 469-930-3077
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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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