Provider Demographics
NPI:1760852859
Name:FLORIDA DIGESTIVE HEALTH SPECIALISTS LIVER CLINIC, LLC
Entity Type:Organization
Organization Name:FLORIDA DIGESTIVE HEALTH SPECIALISTS LIVER CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DITOMASO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-757-4810
Mailing Address - Street 1:10920 TECHNOLOGY TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4930
Mailing Address - Country:US
Mailing Address - Phone:941-216-4835
Mailing Address - Fax:941-216-4836
Practice Address - Street 1:10920 TECHNOLOGY TER
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34211-4930
Practice Address - Country:US
Practice Address - Phone:941-216-4835
Practice Address - Fax:941-216-4836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-01
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Single Specialty