Provider Demographics
NPI:1083742357
Name:DIGESTIVE AND LIVER CENTER OF FL, LLC
Entity Type:Organization
Organization Name:DIGESTIVE AND LIVER CENTER OF FL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SRINIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-384-7388
Mailing Address - Street 1:100 N DEAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3710
Mailing Address - Country:US
Mailing Address - Phone:407-384-7388
Mailing Address - Fax:407-384-7391
Practice Address - Street 1:100 N DEAN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825
Practice Address - Country:US
Practice Address - Phone:407-384-7388
Practice Address - Fax:407-384-7391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93786 & ME93637207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3787208OtherS SEELA, CIGNA ID
FL28608OtherH SHEELA, BCBS PROVIDER #
FL299120OtherAMERIGROUP GROUP ID
FL5243121OtherH SHEELA, CIGNA ID
FL298080OtherS SEELA, WELLCARE ID
FL300724OtherS SEELA, AVMED ID
FL7202746OtherS SEELA, AETNA ID
FL2555472OtherH SHEELA, UNITED HC ID
FL2555475OtherS SEELA, UNITED HC ID
FL28609OtherS SEELA, BCBS PROVIDER ID
FL326781OtherH SHEELA, WELLCARE ID
FL7722696OtherH SHEELA, AETNA INS ID
FL11144901OtherH SHEELA, CITRUS HC ID
FL273851100Medicaid
FL273850300Medicaid
FL2555475OtherS SEELA, UNITED HC ID
FL299120OtherAMERIGROUP GROUP ID
FLU5839AMedicare ID - Type UnspecifiedH SHEELA PROVIDER #
FL7202746OtherS SEELA, AETNA ID
FL326781OtherH SHEELA, WELLCARE ID