| Gastroenterology Care Specialists, Llc | |
|
550 Redstone Ave W Ste 430 Crestview FL 32536-6457 | |
| (850) 398-8605 | |
| Not Available |
| Full Name | Gastroenterology Care Specialists, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 Redstone Ave W Ste 430, Crestview, Florida |
| Authorized Official Name and Position | Khalid Moussa (DR) |
| Authorized Official Contact | 2254055441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Care Specialists, Llc 550 Redstone Ave W Ste 430 Crestview FL 32536-6457 Ph: (850) 398-8605 | Gastroenterology Care Specialists, Llc 550 Redstone Ave W Ste 430 Crestview FL 32536-6457 Ph: (850) 398-8605 |
| NPI Number | 1750922399 |
|---|---|
| Provider Enumeration Date | 10/04/2019 |
| Last Update Date | 10/04/2019 |
| Medicare PECOS PAC ID | 9931531472 |
|---|---|
| Medicare Enrollment ID | O20191121000912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750922399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Khalid M Moussa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922116631 PECOS PAC ID: 1254433675 Enrollment ID: I20140203000427 |
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