Provider Demographics
NPI:1629758180
Name:GASTROENTEROLOGY ASSOCIATES OF NORTHERN VIRGINIA, LLC
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF NORTHERN VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-468-4185
Mailing Address - Street 1:9500 S DADELAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:3028 JAVIER RD STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4622
Practice Address - Country:US
Practice Address - Phone:865-303-8207
Practice Address - Fax:305-675-3378
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTROENTEROLOGY ASSOCIATES OF NORTHERN VIRGINIA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site