Provider Demographics
NPI:1891358792
Name:AMBULATORY ENDOSCOPY CENTER OF CENTRAL FLORIDA, INC.
Entity Type:Organization
Organization Name:AMBULATORY ENDOSCOPY CENTER OF CENTRAL FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
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 1:515 W STATE ROAD 434 STE 105
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5161
Practice Address - Country:US
Practice Address - Phone:407-260-6000
Practice Address - Fax:407-260-2133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTRO HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-16
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical