Provider Demographics
NPI:1548371131
Name:GASTROENTEROLOGY ASSOCIATES OF S FL
Entity type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF S FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-995-7523
Mailing Address - Street 1:6140 SW 70TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3419
Mailing Address - Country:US
Mailing Address - Phone:305-665-7523
Mailing Address - Fax:305-662-9515
Practice Address - Street 1:6140 SW 70TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3419
Practice Address - Country:US
Practice Address - Phone:305-665-7523
Practice Address - Fax:305-662-9515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05595630Medicaid
FL00042Medicare ID - Type Unspecified