Provider Demographics
NPI:1427163682
Name:FLORIDA GASTROENTEROLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:FLORIDA GASTROENTEROLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-780-8620
Mailing Address - Street 1:37908 DAUGHTERY ROAD
Mailing Address - Street 2:STE A
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-1316
Mailing Address - Country:US
Mailing Address - Phone:813-780-8620
Mailing Address - Fax:813-780-8619
Practice Address - Street 1:37908 DAUGHTERY ROAD
Practice Address - Street 2:STE A
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-1316
Practice Address - Country:US
Practice Address - Phone:813-780-8620
Practice Address - Fax:813-780-8619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064410207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH6445OtherRAILROAD MEDICARE
FLK1089Medicare ID - Type UnspecifiedGROUP NUMBER