Provider Demographics
NPI:1013096973
Name:FLORIDA CENTER FOR GASTROENTEROLOGY
Entity Type:Organization
Organization Name:FLORIDA CENTER FOR GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-544-1600
Mailing Address - Street 1:8250 BRYAN DAIRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1353
Mailing Address - Country:US
Mailing Address - Phone:727-544-1600
Mailing Address - Fax:727-545-2555
Practice Address - Street 1:8250 BRYAN DAIRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1353
Practice Address - Country:US
Practice Address - Phone:727-544-1600
Practice Address - Fax:727-545-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34315OtherBCBS
FL264597100Medicaid
FLK3686Medicare ID - Type Unspecified
FL264597100Medicaid