Provider Demographics
NPI:1760877070
Name:CENTER FOR DIGESTIVE MEDICINE PLLC
Entity Type:Organization
Organization Name:CENTER FOR DIGESTIVE MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:M
Authorized Official - Last Name:PINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-825-6729
Mailing Address - Street 1:7887 N KENDALL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7427
Mailing Address - Country:US
Mailing Address - Phone:305-825-6729
Mailing Address - Fax:305-273-6520
Practice Address - Street 1:7887 N KENDALL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7427
Practice Address - Country:US
Practice Address - Phone:305-825-6729
Practice Address - Fax:305-273-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOSR1085OtherFLORIDA BOARD OF MEDICINE