Provider Demographics
NPI:1366404618
Name:GASTROENTEROLOGY SPECIALISTS INC
Entity type:Organization
Organization Name:GASTROENTEROLOGY SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GASTROENTEROLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SABU
Authorized Official - Middle Name:J
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-630-8775
Mailing Address - Street 1:3355 BURNS RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4353
Mailing Address - Country:US
Mailing Address - Phone:561-630-8775
Mailing Address - Fax:561-630-2892
Practice Address - Street 1:3355 BURNS RD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4353
Practice Address - Country:US
Practice Address - Phone:561-630-8775
Practice Address - Fax:561-630-2892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94095174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG70854Medicare UPIN