Provider Demographics
NPI:1790782258
Name:GASTROENTEROLOGY & LIVER CONSULTANTS, P.L
Entity Type:Organization
Organization Name:GASTROENTEROLOGY & LIVER CONSULTANTS, P.L
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-322-9530
Mailing Address - Street 1:1403 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1000
Mailing Address - Country:US
Mailing Address - Phone:407-322-9530
Mailing Address - Fax:407-322-9534
Practice Address - Street 1:1403 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 206
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1000
Practice Address - Country:US
Practice Address - Phone:407-322-9530
Practice Address - Fax:407-322-9534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38903207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID #