| Digestive & Liver Wellness Pa | |
|
925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 | |
| (786) 500-4644 | |
| (786) 530-6862 |
| Full Name | Digestive & Liver Wellness Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 925 Ne 30th Ter Ste 204, Homestead, Florida |
| Authorized Official Name and Position | Sandra Rodriguez (OWNER/PRESIDENT) |
| Authorized Official Contact | 7865004644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive & Liver Wellness Pa 925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 Ph: (786) 500-4644 | Digestive & Liver Wellness Pa 925 Ne 30th Ter Ste 204 Homestead FL 33033-7614 Ph: (786) 500-4644 |
| NPI Number | 1477174662 |
|---|---|
| Provider Enumeration Date | 04/29/2020 |
| Last Update Date | 01/12/2021 |
| Medicare PECOS PAC ID | 5294158101 |
|---|---|
| Medicare Enrollment ID | O20200710002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477174662 | NPI | - | NPPES |
| 100493500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Sandra Rodriguez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164715462 PECOS PAC ID: 4880908508 Enrollment ID: I20181211003304 |
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