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General NPI Number Information
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NPI Number | 1831565688
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE GASTROENTEROLOGY ASSOCIATES
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 15303 AMBERLY DR STE A
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City | TAMPA
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State | FL
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Zip | 33647-2308
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Country | US
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Telephone | 813-751-9727
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Fax | 813-441-7373
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Provider Business Mailing Address
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Address Line | 15303 AMBERLY DR STE A
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City | TAMPA
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State | FL
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Zip | 33647-2308
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Country | US
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Telephone | 813-751-9727
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Fax | 813-441-7373
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Authorized Official
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Title or Position | DOCTOR
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Name | SOBIA ALI
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Credential | MD
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Telephone | 847-525-0020
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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 | ME106694
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License Number State | FL
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