Provider Demographics
NPI:1194595918
Name:BENCHMARK GASTRO, L.L.C.
Entity type:Organization
Organization Name:BENCHMARK GASTRO, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NOBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-514-4778
Mailing Address - Street 1:10676 BLOOMINGDALE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4292
Mailing Address - Country:US
Mailing Address - Phone:352-514-4778
Mailing Address - Fax:813-284-6052
Practice Address - Street 1:10676 BLOOMINGDALE AVE STE 1
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4292
Practice Address - Country:US
Practice Address - Phone:352-514-4778
Practice Address - Fax:813-284-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty