Provider Demographics
NPI:1578810743
Name:VENTURE GASTROENTEROLOGY LLC
Entity Type:Organization
Organization Name:VENTURE GASTROENTEROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:E
Authorized Official - Last Name:NULLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-534-4404
Mailing Address - Street 1:2523 REGATTA AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4234
Mailing Address - Country:US
Mailing Address - Phone:305-654-4488
Mailing Address - Fax:305-654-8157
Practice Address - Street 1:16855 NE 2ND AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1744
Practice Address - Country:US
Practice Address - Phone:305-654-4488
Practice Address - Fax:305-654-8157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty