MEDICARE: GASTRO HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist
2	207RG0100X	Gastroenterology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336661073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTRO HEALTH, LLC

Provider Business Mailing Address
First Line	:	11011 SHERIDAN ST STE 109
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1501
Country	:	US
Telephone Number	:	954-961-8400
Fax Number	:	954-961-8401

Provider Business Practice Location Address
First Line	:	11011 SHERIDAN ST STE 109
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1501
Country	:	US
Telephone Number	:	954-961-8400
Fax Number	:	954-961-8401

Authorized Official
Title or Position	:	CEO
Name	:	ALAN OLIVER
Credential	:
Telephone Number	:	786-530-3820

Provider Enumeration Date	:	07/14/2017
Last Update Date	:	05/12/2025

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Directions to “GASTRO HEALTH, LLC ” Practice Location

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