Gastroenterology Consultants of Polk County PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME0069617 Issued in FL

Legal business name

GASTROENTEROLOGY CONSULTANTS OF POLK COUNTY PA

Practice address

40124 Hwy 27
Suite 102
Davenport, FL 33837-5905

Phone

(863) 419-1166

Fax

(863) 419-1188

NPI assigned

Sep 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jatinder Dhaliwal

Title

Manager

Phone

(863) 419-1166

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leonel Edwards, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Leesburg, FL
  • NPI 1265453963
  Medicare reassignment NPD
• Devendra S Kahlon, M.D.

  • Gastroenterology Physician
  • Davenport, FL
  • NPI 1285668897
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1205021052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40124 HWY 27",
            "address_2": "SUITE 102",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-419-1166",
            "fax_number": "863-419-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40124 HWY 27",
            "address_2": "SUITE 102",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375905",
            "telephone_number": "863-419-1166",
            "fax_number": "863-419-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY CONSULTANTS OF POLK COUNTY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "JATINDER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "863-419-1166"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0069617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379143200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenafer Garcia, ARNP
• Garrovillo Surgical Care LLC
• Mel Francis Garrovillo, M.D.
• Mackenzie Mae Gasal, APRN, CPNP-PC
• Gastro Health, LLC
• GDG Bilingual Therapy Group, LLC
• Maxime G Gedeon, M.D.
• James Louis Gegenheimer, RDN CSCS
• Judith Geneus, LMHC
• Lynda-Marie George, MD

• Gastroenterology Physician in Davenport, FL
• Providers in Davenport, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.