=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821788902
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GASTRO HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2023
-----------------------------------------------------
Last Update Date | 05/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7261 SHERIDAN ST STE 100C
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-2708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-441-6226
-----------------------------------------------------
Fax | 954-443-3994
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7261 SHERIDAN ST STE 100C
-----------------------------------------------------
City | HOLLYWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33024-2708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-441-6226
-----------------------------------------------------
Fax | 954-443-3994
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ALAN OLIVER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 786-530-3820
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------