| Gastroenterology Consultants Of Central Florida Pa | |
|
10800 Dylan Loren Cir Suite 102 Orlando FL 32825-4437 | |
| (407) 277-8665 | |
| (407) 277-1267 |
| Full Name | Gastroenterology Consultants Of Central Florida Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 10800 Dylan Loren Cir, Orlando, Florida |
| Authorized Official Name and Position | Keith R Moore (PHYSICIAN) |
| Authorized Official Contact | 4072778665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Consultants Of Central Florida Pa 10800 Dylan Loren Cir Suite 102 Orlando FL 32825-4437 Ph: (407) 277-8665 | Gastroenterology Consultants Of Central Florida Pa 10800 Dylan Loren Cir Suite 102 Orlando FL 32825-4437 Ph: (407) 277-8665 |
| NPI Number | 1083603625 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3870577653 |
|---|---|
| Medicare Enrollment ID | O20040617001122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083603625 | NPI | - | NPPES |
| 003313200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Aniq Shaikh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043209695 PECOS PAC ID: 9436133212 Enrollment ID: I20040617001191 |
| Provider Name | Nilofar J Ali |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861585648 PECOS PAC ID: 7719111400 Enrollment ID: I20131011001549 |
| Provider Name | Shaquana Suzan Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124769617 PECOS PAC ID: 1658750369 Enrollment ID: I20220625000367 |
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