| Fl0062m | |
|
740 Concourse Pkwy S Ste 200 Maitland FL 32751-8101 | |
| (407) 644-4014 | |
| (407) 644-5270 |
| Full Name | Fl0062m |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 740 Concourse Pkwy S Ste 200, Maitland, Florida |
| Authorized Official Name and Position | Alan Oliver (CEO) |
| Authorized Official Contact | 7865303820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fl0062m 9200 S Dadeland Blvd Ste 800 Miami FL 33156-2758 Ph: (786) 530-3820 | Fl0062m 740 Concourse Pkwy S Ste 200 Maitland FL 32751-8101 Ph: (407) 644-4014 |
| NPI Number | 1922921857 |
|---|---|
| Provider Enumeration Date | 07/30/2026 |
| Last Update Date | 07/30/2026 |
| Certification Date | 07/30/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922921857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | () | Primary |
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