| Fl052 | |
|
1157 S State Road 7 Wellington FL 33414-6101 | |
| (561) 214-6695 | |
| (561) 214-6740 |
| Full Name | Fl052 |
|---|---|
| Speciality | Pediatrics - Pediatric Gastroenterology |
| Location | 1157 S State Road 7, Wellington, Florida |
| Authorized Official Name and Position | Joseph Garcia (CEO) |
| Authorized Official Contact | 3054684185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fl052 1157 S State Road 7 Wellington FL 33414-6101 Ph: (561) 214-6695 | Fl052 1157 S State Road 7 Wellington FL 33414-6101 Ph: (561) 214-6695 |
| NPI Number | 1952071581 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 04/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952071581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | (* (Not Available)) | Primary |
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