| St Cloud Gastroenterology Pllc | |
|
2801 13th Street Saint Cloud FL 34769 | |
| (407) 892-8925 | |
| (407) 892-8926 |
| Full Name | St Cloud Gastroenterology Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2801 13th Street, Saint Cloud, Florida |
| Authorized Official Name and Position | Rafael Fleites (OWNER) |
| Authorized Official Contact | 4078928925 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Cloud Gastroenterology Pllc 2801 13th Street Saint Cloud FL 34769-4134 Ph: (407) 892-8925 | St Cloud Gastroenterology Pllc 2801 13th Street Saint Cloud FL 34769 Ph: (407) 892-8925 |
| NPI Number | 1518382647 |
|---|---|
| Provider Enumeration Date | 02/26/2014 |
| Last Update Date | 09/04/2018 |
| Medicare PECOS PAC ID | 2961625546 |
|---|---|
| Medicare Enrollment ID | O20140529001305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518382647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | ME35796 (Florida) | Primary |
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