Provider Demographics
NPI:1497482160
Name:MIAMI GASTRO AT THE KEYS, P.A.
Entity Type:Organization
Organization Name:MIAMI GASTRO AT THE KEYS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:AVALOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-589-5298
Mailing Address - Street 1:PO BOX 801240
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33280-1240
Mailing Address - Country:US
Mailing Address - Phone:786-589-5298
Mailing Address - Fax:209-420-9737
Practice Address - Street 1:103400 OVERSEAS HWY STE 251
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2831
Practice Address - Country:US
Practice Address - Phone:786-589-5298
Practice Address - Fax:509-420-9737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty