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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1346918653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTRO HEALTH, LLC

Provider Business Mailing Address
First Line	:	6517 TAFT ST STE 101
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	954-476-9350
Fax Number	:	877-227-8303

Provider Business Practice Location Address
First Line	:	6517 TAFT ST STE 101
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-4063
Country	:	US
Telephone Number	:	954-476-9350
Fax Number	:	877-227-8303

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

Provider Enumeration Date	:	09/01/2021
Last Update Date	:	05/12/2025

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