Provider Demographics
NPI:1285272815
Name:GASTRO FLORIDA PHARMACY, LLC
Entity type:Organization
Organization Name:GASTRO FLORIDA PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALYANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-347-0536
Mailing Address - Street 1:3001 EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762
Mailing Address - Country:US
Mailing Address - Phone:727-347-0536
Mailing Address - Fax:727-329-3377
Practice Address - Street 1:3001 EXECUTIVE DRIVE
Practice Address - Street 2:SUITE 130
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762
Practice Address - Country:US
Practice Address - Phone:727-347-0536
Practice Address - Fax:727-329-3377
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST CENTRAL GASTROENTEROLOGY, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy