| Advanced Gastroenterology And Hepatology | |
|
6817 Southpoint Pkwy Ste 102 Jacksonville FL 32216-6285 | |
| (904) 513-3998 | |
| (904) 575-4919 |
| Full Name | Advanced Gastroenterology And Hepatology |
|---|---|
| Speciality | Internal Medicine |
| Location | 6817 Southpoint Pkwy Ste 102, Jacksonville, Florida |
| Authorized Official Name and Position | Xiaoyu Li (PRESIDENT/OWNER) |
| Authorized Official Contact | 9045133998 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Gastroenterology And Hepatology 6817 Southpoint Pkwy Ste 102 Jacksonville FL 32216-6285 Ph: (904) 513-3998 | Advanced Gastroenterology And Hepatology 6817 Southpoint Pkwy Ste 102 Jacksonville FL 32216-6285 Ph: (904) 513-3998 |
| NPI Number | 1417408683 |
|---|---|
| Provider Enumeration Date | 10/21/2016 |
| Last Update Date | 08/20/2019 |
| Medicare PECOS PAC ID | 5597047449 |
|---|---|
| Medicare Enrollment ID | O20170130000476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417408683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME92069 (Florida) | Primary |
| 207RI0008X | Internal Medicine - Hepatology | ME92069 (Florida) | Secondary |
| Provider Name | Xiaoyu Li |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790846988 PECOS PAC ID: 6709972391 Enrollment ID: I20071011000692 |
| Provider Name | Christina M Tancreto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750839205 PECOS PAC ID: 5597045336 Enrollment ID: I20161213001248 |
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