| Digestive 305 Llc | |
|
940 Hunting Lodge Drive Miami Springs FL 33166 | |
| (305) 505-7714 | |
| Not Available |
| Full Name | Digestive 305 Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 940 Hunting Lodge Drive, Miami Springs, Florida |
| Authorized Official Name and Position | Nguyen Caballero (MANAGER) |
| Authorized Official Contact | 3055057714 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive 305 Llc 10 Canal St Ste 277 Miami Springs FL 33166-4404 Ph: (305) 505-7714 | Digestive 305 Llc 940 Hunting Lodge Drive Miami Springs FL 33166 Ph: (305) 505-7714 |
| NPI Number | 1295599355 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 02/09/2024 |
| Medicare PECOS PAC ID | 4284177890 |
|---|---|
| Medicare Enrollment ID | O20240624000872 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295599355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Nguyen Caballero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467119917 PECOS PAC ID: 3779592308 Enrollment ID: I20220525000957 |
| Provider Name | Onix Garib Alpizar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003268715 PECOS PAC ID: 7517338551 Enrollment ID: I20230130001434 |
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