| Digestive Diseases Care For All Llc | |
|
805 East Garden Street Lakeland FL 33805-4616 | |
| (863) 802-1111 | |
| (863) 802-6711 |
| Full Name | Digestive Diseases Care For All Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 805 East Garden Street, Lakeland, Florida |
| Authorized Official Name and Position | Mahmudul Haque (OWNER) |
| Authorized Official Contact | 8638021111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Diseases Care For All Llc Po Box 249 Highland City FL 33846-0249 Ph: (863) 687-8335 | Digestive Diseases Care For All Llc 805 East Garden Street Lakeland FL 33805-4616 Ph: (863) 802-1111 |
| NPI Number | 1346484565 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 10/30/2014 |
| Medicare PECOS PAC ID | 3870632490 |
|---|---|
| Medicare Enrollment ID | O20091120000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346484565 | NPI | - | NPPES |
| 274846100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0100X | Internal Medicine - Gastroenterology | ME93947 (Florida) | Primary |
| Provider Name | Mahmudul Haque |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699987800 PECOS PAC ID: 8820021090 Enrollment ID: I20050917000078 |
| Provider Name | Eliezer M Izsak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740389261 PECOS PAC ID: 2860460177 Enrollment ID: I20120810000561 |
| Provider Name | Jackie D Hatten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639607732 PECOS PAC ID: 7113286980 Enrollment ID: I20180124001798 |
| Provider Name | Juan J Pineda |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386649812 PECOS PAC ID: 4789643537 Enrollment ID: I20211104000953 |
| Provider Name | Andrea Stallworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598412066 PECOS PAC ID: 5294113023 Enrollment ID: I20220607000200 |
| Provider Name | Pamela Bearden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871291419 PECOS PAC ID: 8123486933 Enrollment ID: I20230626002310 |
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