MEDICARE: MID FLORIDA GASTROENTEROLOGY CONSULTANTS 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1689762924	OTHER	FL	INDIVIDUAL NPI #

General Provider Information

NPI Number	:	1740378009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	10000 W COLONIAL DR STE 389
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-3433
Country	:	US
Telephone Number	:	407-822-1171
Fax Number	:	407-822-1172

Provider Business Practice Location Address
First Line	:	10000 W COLONIAL DR STE 389
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-3433
Country	:	US
Telephone Number	:	407-822-1171
Fax Number	:	407-822-1172

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MOHAMMAD REZA MASTALI
Credential	:	M.D.
Telephone Number	:	407-822-1171

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/13/2011

Similar Medicare Providers

1053937730 — BENEDICT HILADO
Practice Location Address:

10000 W COLONIAL DR STE 382
OCOEE, FL
34761-3433

Practice Phone: 321-841-2800
Practice Fax: 321-841-4504

1962401315 — ALFONSO PRECIADO MD
Practice Location Address:

10000 W COLONIAL DR STE 393
OCOEE, FL
34761-3433

Practice Phone: 321-843-1378
Practice Fax: 407-296-1873

1548398902 — MS. BRIDGETTE A MITCHELL ARNP
Practice Location Address:

10000 W COLONIAL DR STE 482
OCOEE, FL
34761-3433

Practice Phone: 321-841-6444
Practice Fax: 407-650-1307

1518252212 — DR. ROSHAN ASHOKKUMAR PATEL M.D.
Practice Location Address:

10000 W COLONIAL DR STE 394
OCOEE, FL
34761-3433

Practice Phone: 321-843-1378
Practice Fax: 321-843-5177

1134501646 — BRADLEY GADDIS D.O.
Practice Location Address:

10000 W COLONIAL DR STE 393
OCOEE, FL
34761-3433

Practice Phone: 407-296-1871
Practice Fax:

1073967907 — DR. MAXIM ANTHONY OLIVIER JR. M.D.
Practice Location Address:

10000 W COLONIAL DR STE 482
OCOEE, FL
34761-3433

Practice Phone: 321-841-6444
Practice Fax: 407-290-2118

Directions to “MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.