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NPI Code Detail

MEDICARE: VENTURE GASTROENTEROLOGY LLC

MEDICARE: VENTURE GASTROENTEROLOGY 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
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1720335995
Entity Type Code : Organization
Provider Name (Legal Business Name) : VENTURE GASTROENTEROLOGY LLC
Provider Business Mailing Address
First Line : 2523 REGATTA AVE
Second Line :
City : MIAMI BEACH
State : FL
Zip : 33140-4234
Country : US
Telephone Number : 305-654-4488
Fax Number : 305-654-8157
Provider Business Practice Location Address
First Line : 1117 E HALLANDALE BEACH BLVD STE 1
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-4488
Country : US
Telephone Number : 305-933-3170
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ANDREW E NULLMAN
Credential : MD
Telephone Number : 305-534-4404
Provider Enumeration Date : 08/07/2012
Last Update Date : 11/08/2021

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Directions to “VENTURE GASTROENTEROLOGY LLC ” Practice Location

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