Provider Demographics
NPI:1194413815
Name:GASTRO HEALTH, LLC
Entity type:Organization
Organization Name:GASTRO HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-530-3820
Mailing Address - Street 1:515 W STATE ROAD 434 STE 141
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4981
Mailing Address - Country:US
Mailing Address - Phone:407-260-6000
Mailing Address - Fax:407-260-2133
Practice Address - Street 1:515 W STATE ROAD 434 STE 141
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4981
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:2023-05-01
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty