Provider Demographics
NPI:1659381614
Name:ADVANCED GASTROENTEROLOGY OF NAPLES, LLC
Entity Type:Organization
Organization Name:ADVANCED GASTROENTEROLOGY OF NAPLES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARDUL
Authorized Official - Middle Name:ASHWIN
Authorized Official - Last Name:NANAVATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-593-9599
Mailing Address - Street 1:4760 TAMIAMI TRL N
Mailing Address - Street 2:STE 27
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3025
Mailing Address - Country:US
Mailing Address - Phone:239-593-9599
Mailing Address - Fax:239-593-4099
Practice Address - Street 1:4760 TAMIAMI TRL N
Practice Address - Street 2:STE 27
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3025
Practice Address - Country:US
Practice Address - Phone:239-593-9599
Practice Address - Fax:239-593-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92248207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BN9086819OtherDEA