Provider Demographics
NPI:1316635030
Name:GASTRO HEALTH, LLC
Entity type:Organization
Organization Name:GASTRO HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-468-4185
Mailing Address - Street 1:1722 STATE ROAD 44 # 390
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-8339
Mailing Address - Country:US
Mailing Address - Phone:386-427-0390
Mailing Address - Fax:386-427-0394
Practice Address - Street 1:1722 STATE ROAD 44 # 390
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-8339
Practice Address - Country:US
Practice Address - Phone:386-427-0390
Practice Address - Fax:386-427-0394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTRO HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty