Active NPI
Florida Digestive and Liver Specialists PA
- Gastroenterology Physician
- Melbourne, FL
National Provider Identifier
1215154661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME79573
- Legal business name
- FLORIDA DIGESTIVE AND LIVER SPECIALISTS PA
- Practice address
- 25 Silver Palm Ave
Melbourne, FL 32901-3177 - Phone
- (321) 725-4150
- Fax
- (321) 733-1335
- NPI assigned
- Apr 19, 2007
- Last updated
- Sep 15, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Liz Mazara
- Title
- Billing Department
- Phone
- (321) 752-5210
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME79573 | FL | Primary |
Addresses
Primary practice location
25 Silver Palm Ave
Melbourne, FL 32901-3177
Mailing address
25 Silver Palm Ave
Melbourne, FL 32901-3177
Phone (321) 725-4150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
25 Silver Palm Ave
Ste B
Melbourne, FL 32901
Phone (321) 725-4150
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anatomic Pathology & Clinical Pathology Physician
- Orlando, FL
- NPI 1841272853
-
- Gastroenterology Physician
- Melbourne, FL
- NPI 1700983863
-
- Anatomic Pathology & Clinical Pathology Physician
- South Miami, FL
- NPI 1508278532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1284508800000",
"number": "1215154661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 SILVER PALM AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013177",
"telephone_number": "321-725-4150",
"fax_number": "321-733-1335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 SILVER PALM AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013177",
"telephone_number": "321-725-4150",
"fax_number": "321-733-1335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLORIDA DIGESTIVE AND LIVER SPECIALISTS PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-19",
"last_updated": "2010-09-15",
"status": "A",
"authorized_official_last_name": "MAZARA",
"authorized_official_first_name": "LIZ",
"authorized_official_title_or_position": "BILLING DEPARTMENT",
"authorized_official_telephone_number": "321-752-5210"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME79573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.