| Gastroenterology & Motility Center Llc | |
|
1951 Sw 172nd Ave Ste 312 Miramar FL 33029-5614 | |
| (917) 399-8112 | |
| Not Available |
| Full Name | Gastroenterology & Motility Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1951 Sw 172nd Ave Ste 312, Miramar, Florida |
| Authorized Official Name and Position | Su Bin Kim (OWNDER) |
| Authorized Official Contact | 9173998112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology & Motility Center Llc 1870 N Corporate Lakes Blvd Unit 266114 Weston FL 33326-8800 Ph: () - | Gastroenterology & Motility Center Llc 1951 Sw 172nd Ave Ste 312 Miramar FL 33029-5614 Ph: (917) 399-8112 |
| NPI Number | 1104681824 |
|---|---|
| Provider Enumeration Date | 02/21/2024 |
| Last Update Date | 10/03/2024 |
| Medicare PECOS PAC ID | 5597106054 |
|---|---|
| Medicare Enrollment ID | O20240515000847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104681824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Su Bin Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679826416 PECOS PAC ID: 6709123003 Enrollment ID: I20190124001680 |
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