MEDICARE: MIAMI GASTRO AT THE KEYS, P.A.

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

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	:	1497482160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIAMI GASTRO AT THE KEYS, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 801240
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33280-1240
Country	:	US
Telephone Number	:	786-589-5298
Fax Number	:	209-420-9737

Provider Business Practice Location Address
First Line	:	103400 OVERSEAS HWY STE 251
Second Line	:
City	:	KEY LARGO
State	:	FL
Zip	:	33037-2831
Country	:	US
Telephone Number	:	786-589-5298
Fax Number	:	509-420-9737

Authorized Official
Title or Position	:	OWNER
Name	:	DANNY JUAN AVALOS
Credential	:	MD
Telephone Number	:	786-589-5298

Provider Enumeration Date	:	08/03/2022
Last Update Date	:	08/03/2022

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Directions to “MIAMI GASTRO AT THE KEYS, P.A. ” Practice Location

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