| Functional And Interventional Gastroenterology Pllc | |
|
10004 N Dale Mabry Hwy Ste 101 Tampa FL 33618-4421 | |
| (813) 364-8863 | |
| (813) 738-4889 |
| Full Name | Functional And Interventional Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10004 N Dale Mabry Hwy Ste 101, Tampa, Florida |
| Authorized Official Name and Position | Arthi Sanjeevi (PRESIDENT) |
| Authorized Official Contact | 8133648863 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Functional And Interventional Gastroenterology Pllc Po Box 273391 Tampa FL 33688-3391 Ph: (813) 364-8863 | Functional And Interventional Gastroenterology Pllc 10004 N Dale Mabry Hwy Ste 101 Tampa FL 33618-4421 Ph: (813) 364-8863 |
| NPI Number | 1891554820 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 06/30/2024 |
| Medicare PECOS PAC ID | 0244671816 |
|---|---|
| Medicare Enrollment ID | O20240514001353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891554820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Arthi Sanjeevi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497768550 PECOS PAC ID: 9537168406 Enrollment ID: I20100917000044 |
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