Provider Type Icon

PEDIATRIC GASTROENTEROLOGY OF FLORIDA PA NPI 1093952152


NPI Information

NPI: 1093952152
Provider Name: PEDIATRIC GASTROENTEROLOGY OF FLORIDA , PA
Classification: Pediatrics - 2080P0206X
Entity Type: Organization

Specialization: Pediatric Gastroenterology

Address:
13770 PLANTATION RD
UNIT 4
FORT MYERS, FL
ZIP 33912
Phone: (239) 561-6365
Get Directions

PEDIATRIC GASTROENTEROLOGY OF FLORIDA , PA is a pediatric gastroenterology pediatrics in Fort Myers, FL. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. PEDIATRIC GASTROENTEROLOGY OF FLORIDA , PA NPI is 1093952152. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13770 PLANTATION RD
UNIT 4
FORT MYERS, FL
ZIP 33912-460
Phone: (239) 561-6365
Fax: (239) 561-6264

The provider's authorized official is Jayshree Ganatra .
The authorized official title is President and has the following contact phone number (239) 561-6365.

The enumeration date for this NPI number is 1/12/2009 and was last updated on 3/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0206XPediatricsPediatric GastroenterologyME82537FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1262706600MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.