| Gastroenterology Institute Of Orlando Llc | |
|
1111 S Semoran Blvd Suite A Orlando FL 32807-1480 | |
| (407) 456-3079 | |
| Not Available |
| Full Name | Gastroenterology Institute Of Orlando Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 S Semoran Blvd, Orlando, Florida |
| Authorized Official Name and Position | Seela Ramesh (PRESIDENT) |
| Authorized Official Contact | 4074563079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Institute Of Orlando Llc 1111 S Semoran Blvd Suite A Orlando FL 32807-1480 Ph: (407) 456-3079 | Gastroenterology Institute Of Orlando Llc 1111 S Semoran Blvd Suite A Orlando FL 32807-1480 Ph: (407) 456-3079 |
| NPI Number | 1225493729 |
|---|---|
| Provider Enumeration Date | 12/28/2015 |
| Last Update Date | 04/18/2017 |
| Medicare PECOS PAC ID | 1355619586 |
|---|---|
| Medicare Enrollment ID | O20170613000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225493729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME106233 (Florida) | Primary |
| Provider Name | Seela Ramesh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184849630 PECOS PAC ID: 9638262983 Enrollment ID: I20100325000810 |
| Provider Name | Nilofar J Ali |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861585648 PECOS PAC ID: 7719111400 Enrollment ID: I20131011001549 |
| Provider Name | Shoba Theivanayagam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730388067 PECOS PAC ID: 6103060769 Enrollment ID: I20210521002131 |
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