Provider Demographics
NPI:1003009093
Name:DIGESTIVE HEALTH PHYSICIANS OF CENTRAL FLORIDA PA
Entity Type:Organization
Organization Name:DIGESTIVE HEALTH PHYSICIANS OF CENTRAL FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PANARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-519-0902
Mailing Address - Street 1:1350 E MAIN ST STE C-2
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-5064
Mailing Address - Country:US
Mailing Address - Phone:863-519-0902
Mailing Address - Fax:863-519-0904
Practice Address - Street 1:1350 E MAIN ST STE C-2
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-5064
Practice Address - Country:US
Practice Address - Phone:863-519-0902
Practice Address - Fax:863-519-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7221Medicare PIN