DIGESTIVE DISEASE SPECIALIST OF MANATEE PL NPI 1174655211

NPI Information

NPI: 1174655211
Provider Name: DIGESTIVE DISEASE SPECIALIST OF MANATEE PL

Doing Business As: DDSOM

Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
4502 CORTEZ RD W STE 204
BRADENTON, FL
ZIP 34210
Phone: (941) 761-1800
Get Directions

DIGESTIVE DISEASE SPECIALIST OF MANATEE PL is a gastroenterology internal medicine in Bradenton, FL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. DIGESTIVE DISEASE SPECIALIST OF MANATEE PL NPI is 1174655211. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ddsom.

The provider's business location address is:

4502 CORTEZ RD W STE 204
BRADENTON, FL
ZIP 34210-124
Phone: (941) 761-1800

The provider's authorized official is Rimantas Zalepuga .
The authorized official title is Member and has the following contact phone number (941) 761-1800.

The CLIA number assigned to this NPI record is 10D1095975 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/12/2007 and was last updated on 8/11/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RG0100X	Internal Medicine	Gastroenterology	ME85682	FLORIDA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	74735	OTHER	FLORIDA	BCBS
2	DC1249	OTHER	FLORIDA	RAIL ROAD MEDICARE
3	9751349	OTHER	FLORIDA	GHI
4	271367500	MEDICAID	FLORIDA
5	6102336	OTHER	FLORIDA	CIGNA

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

NPI Synchronization or Removal

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