| Advanced Gastroenterology Of Central Florida | |
|
1036 Mann St Kissimmee FL 34741-4121 | |
| (407) 518-7277 | |
| (407) 785-3234 |
| Full Name | Advanced Gastroenterology Of Central Florida |
|---|---|
| Speciality | Internal Medicine |
| Location | 1036 Mann St, Kissimmee, Florida |
| Authorized Official Name and Position | Vinay Katukuri (OWNER) |
| Authorized Official Contact | 4075187277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Gastroenterology Of Central Florida 9462 Becker Ct Orlando FL 32827-4304 Ph: (407) 518-7277 | Advanced Gastroenterology Of Central Florida 1036 Mann St Kissimmee FL 34741-4121 Ph: (407) 518-7277 |
| NPI Number | 1780149120 |
|---|---|
| Provider Enumeration Date | 02/08/2019 |
| Last Update Date | 08/26/2019 |
| Medicare PECOS PAC ID | 9931434131 |
|---|---|
| Medicare Enrollment ID | O20190710002316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780149120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Vinay K Katukuri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992860597 PECOS PAC ID: 2365490323 Enrollment ID: I20190830000604 |
| Provider Name | Talanda Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972059442 PECOS PAC ID: 7517328834 Enrollment ID: I20230803000713 |
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