| Clinical Gi And Hepatology Services Llc | |
|
1648 Derby Glen Dr Orlando FL 32837-8131 | |
| (407) 760-4598 | |
| Not Available |
| Full Name | Clinical Gi And Hepatology Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1648 Derby Glen Dr, Orlando, Florida |
| Authorized Official Name and Position | Mahmudul Haq (OWNER) |
| Authorized Official Contact | 4077604598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Gi And Hepatology Services Llc 1648 Derby Glen Dr Orlando FL 32837-8131 Ph: (407) 760-4598 | Clinical Gi And Hepatology Services Llc 1648 Derby Glen Dr Orlando FL 32837-8131 Ph: (407) 760-4598 |
| NPI Number | 1972039345 |
|---|---|
| Provider Enumeration Date | 05/04/2017 |
| Last Update Date | 12/01/2021 |
| Medicare PECOS PAC ID | 7315207560 |
|---|---|
| Medicare Enrollment ID | O20180207001975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972039345 | NPI | - | NPPES |
| 14LIJ | Other | FL | BCBS |
| 109395700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Mahmudul Haq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619911146 PECOS PAC ID: 5597928010 Enrollment ID: I20120521000463 |
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