Miami Gastro Llc | |
925 Ne 30th Ter Ste 308 Homestead FL 33033-7614 | |
(305) 974-4822 | |
(509) 420-9737 |
Full Name | Miami Gastro Llc |
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Speciality | Internal Medicine |
Location | 925 Ne 30th Ter Ste 308, Homestead, Florida |
Authorized Official Name and Position | Danny J Avalos (OWNER) |
Authorized Official Contact | 3059744822 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Miami Gastro Llc Po Box 800640 Miami FL 33280-0640 Ph: (305) 974-4822 | Miami Gastro Llc 925 Ne 30th Ter Ste 308 Homestead FL 33033-7614 Ph: (305) 974-4822 |
NPI Number | 1033733563 |
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Provider Enumeration Date | 06/01/2020 |
Last Update Date | 06/01/2020 |
Medicare PECOS PAC ID | 2769807718 |
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Medicare Enrollment ID | O20200807000765 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033733563 | NPI | - | NPPES |
101941600 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Danny J Avalos |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1154664118 PECOS PAC ID: 9234414863 Enrollment ID: I20190521002706 |
Provider Name | Irma B Velazquez Salcedo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245992098 PECOS PAC ID: 1254797418 Enrollment ID: I20230515001928 |
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