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General NPI Number Information
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NPI Number | 1831842640
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY ASSOCIATES OF PENSACOLA PA
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Dates
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Enumeration Date | 02/01/2022
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 14122 ALABAMA ST.
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City | JAY
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State | FL
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Zip | 32565-4122
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Country | US
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Telephone | 850-436-4563
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Fax |
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Provider Business Mailing Address
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Address Line | 9500 S DADELAND BLVD STE 200
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City | MIAMI
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State | FL
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Zip | 33156-2866
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Country | US
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Telephone | 305-468-4185
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALAN OLIVER
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Credential | CEO
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Telephone | 786-530-3820
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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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