| Gastro Md Florida, Llc | |
|
2884 Wellness Ave Ste 100 Orange City FL 32763-8427 | |
| (386) 668-2221 | |
| (386) 668-2228 |
| Full Name | Gastro Md Florida, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2884 Wellness Ave Ste 100, Orange City, Florida |
| Authorized Official Name and Position | Vishal Gupta (PRESIDENT) |
| Authorized Official Contact | 3866682221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastro Md Florida, Llc 2884 Wellness Ave Ste 100 Orange City FL 32763-8427 Ph: (386) 668-2221 | Gastro Md Florida, Llc 2884 Wellness Ave Ste 100 Orange City FL 32763-8427 Ph: (386) 668-2221 |
| NPI Number | 1821167230 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 11/10/2020 |
| Medicare PECOS PAC ID | 2264432558 |
|---|---|
| Medicare Enrollment ID | O20070111000041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821167230 | NPI | - | NPPES |
| AB449 | Other | FL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Florida) | Primary |
| Provider Name | Vishal Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255449179 PECOS PAC ID: 6608895016 Enrollment ID: I20051115000768 |
| Provider Name | James K Allen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073592812 PECOS PAC ID: 6305855768 Enrollment ID: I20060418000162 |
| Provider Name | Martin R Austria |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902885999 PECOS PAC ID: 8426067588 Enrollment ID: I20060418000447 |
| Provider Name | Meredith Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760715569 PECOS PAC ID: 3173648060 Enrollment ID: I20100915001000 |
| Provider Name | Donna R Powell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740459676 PECOS PAC ID: 5496908022 Enrollment ID: I20130110000398 |
| Provider Name | Renee M Marchioni Beery |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750618955 PECOS PAC ID: 6507154440 Enrollment ID: I20161010001790 |
| Provider Name | Karl Tamas Mersich |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275633737 PECOS PAC ID: 3274533021 Enrollment ID: I20180312002192 |
| Provider Name | Dany Karam Shamoun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760456677 PECOS PAC ID: 9032195805 Enrollment ID: I20190730002433 |
| Provider Name | Juan Mercado |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922362516 PECOS PAC ID: 6305157926 Enrollment ID: I20200116002258 |
| Provider Name | Jennifer A Sinclair |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295900108 PECOS PAC ID: 5890853147 Enrollment ID: I20200513002319 |
| Provider Name | Archi Patel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1710368501 PECOS PAC ID: 7618390063 Enrollment ID: I20200702000696 |
| Provider Name | Soroya M Rahaman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669448049 PECOS PAC ID: 7810964129 Enrollment ID: I20210305001127 |
| Provider Name | Richard Dinis Ferrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689243610 PECOS PAC ID: 9436522166 Enrollment ID: I20230228002929 |
| Provider Name | Ahmed Alaa Elbanna |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003279761 PECOS PAC ID: 7810281417 Enrollment ID: I20230713003869 |
| Provider Name | Wei Lu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497284764 PECOS PAC ID: 8022387711 Enrollment ID: I20230717001213 |
| Provider Name | Rebecca Kochanowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033803044 PECOS PAC ID: 8527428721 Enrollment ID: I20230719004238 |
| Provider Name | Alakh Gulati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407397656 PECOS PAC ID: 2769843473 Enrollment ID: I20230727003048 |
| Provider Name | Litza Hernandez-munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497531420 PECOS PAC ID: 3678927969 Enrollment ID: I20230920001400 |
| Provider Name | Priyanka Arpan Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346029550 PECOS PAC ID: 6608221882 Enrollment ID: I20231007000166 |
| Provider Name | Liurka V Lopez |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801145032 PECOS PAC ID: 5294026696 Enrollment ID: I20231106001451 |
| Provider Name | Homayra Fahmida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467211102 PECOS PAC ID: 3779925557 Enrollment ID: I20240524000748 |
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