Digestive & Liver Wellness Pa | |
925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 | |
(786) 500-4644 | |
(786) 530-6862 |
Full Name | Digestive & Liver Wellness Pa |
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Speciality | Internal Medicine |
Location | 925 Ne 30th Ter Ste 204, Homestead, Florida |
Authorized Official Name and Position | Sandra Rodriguez (OWNER/PRESIDENT) |
Authorized Official Contact | 7865004644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Digestive & Liver Wellness Pa 925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 Ph: (786) 500-4644 | Digestive & Liver Wellness Pa 925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 Ph: (786) 500-4644 |
NPI Number | 1477174662 |
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Provider Enumeration Date | 04/29/2020 |
Last Update Date | 01/12/2021 |
Medicare PECOS PAC ID | 5294158101 |
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Medicare Enrollment ID | O20200710002429 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477174662 | NPI | - | NPPES |
100493500 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Sandra Rodriguez |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1164715462 PECOS PAC ID: 4880908508 Enrollment ID: I20181211003304 |
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