Provider Demographics
NPI:1295412740
Name:GSAREEN, LLC.,
Entity type:Organization
Organization Name:GSAREEN, LLC.,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING
Authorized Official - Phone:305-606-0337
Mailing Address - Street 1:12977 SOUTHERN BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9256
Mailing Address - Country:US
Mailing Address - Phone:561-879-4006
Mailing Address - Fax:561-879-4008
Practice Address - Street 1:12977 SOUTHERN BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9256
Practice Address - Country:US
Practice Address - Phone:561-879-4006
Practice Address - Fax:561-879-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty