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MID-FLORIDA GASTROENTEROLOGY GROUP P A NPI 1841474103


NPI Information

NPI: 1841474103
Provider Name: MID-FLORIDA GASTROENTEROLOGY GROUP P A
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
311 N MANGOUSTINE AVE
SANFORD, FL
ZIP 32771
Phone: (407) 321-4570
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MID-FLORIDA GASTROENTEROLOGY GROUP P A is a specialist in Sanford, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MID-FLORIDA GASTROENTEROLOGY GROUP P A NPI is 1841474103. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

311 N MANGOUSTINE AVE
SANFORD, FL
ZIP 32771-098
Phone: (407) 321-4570
Fax: (407) 321-7690

The provider's authorized official is Lenkala Reddy Mallaiah .
The authorized official title is President and has the following contact phone number (407) 321-4570.

The enumeration date for this NPI number is 12/21/2007 and was last updated on 9/20/2010.


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
1174400000XSpecialistME0037029FLORIDAYes

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
177496OTHERMEDICARE
2110047015OTHERFLORIDARAILROAD MEDICARE
3CB7606OTHERFLORIDARAILROAD MEDICARE
477496MEDICARE PINFLORIDA
5065414100MEDICAIDFLORIDA

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: 5/5/2024

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