Organization Name: | GASTROINTESTINAL ASSOCIATES PA |
NPI Number: | 1407902539 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LOUIS M AGNONE (COORDINATING PARTNER) |
Mailing Address: | 3635 S Clyde Morris Blvd Suite 100 Port Orange |
State: | FL US |
Postal Code: | 321292300 |
Phone Number: | 3867881242 |
Fax Number: | 3867884255 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 05/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME56146 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |