NPIMap

Organization Active NPI

Digestive Diseases Care for All LLC

  • Gastroenterology Physician
  • Lakeland, FL
National Provider Identifier
1346484565
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME93947 Issued in FL
Legal business name
DIGESTIVE DISEASES CARE FOR ALL LLC
Practice address
805 East Garden Street
Lakeland, FL 33805-4616
Phone
(863) 802-1111
Fax
(863) 802-6711
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Authorized official

Name
Dr. Mahmudul Haque, M.D.NPI 1699987800
Title
Owner
Phone
(863) 802-1111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X ME93947 FL Primary

Addresses

Primary practice location

805 East Garden Street
Lakeland, FL 33805-4616

Mailing address

PO Box 249
Highland City, FL 33846-0249
Phone (863) 687-8335

Other identifiers 1

IdentifierTypeStateIssuer
274846100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091120000116 FL Part B Supplier - Clinic/Group Practice 3870632490 Receives reassigned benefits from 10 practitioners
Practice locations: Lakeland, FL; Winter Haven, FL; Bartow, FL

National Provider Directory

National Provider Directory

Locations

2250 Osprey Blvd
Ste 103
Bartow, FL 33830
Phone (863) 676-6386

1114 S Florida Ave
Lakeland, FL 33803
Phone (863) 500-1773

508 E Garden St
Lakeland, FL 33805
Phone (813) 688-2447

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1346484565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "HIGHLAND CITY",
            "state": "FL",
            "postal_code": "338460249",
            "telephone_number": "863-687-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 EAST GARDEN STREET",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054616",
            "telephone_number": "863-802-1111",
            "fax_number": "863-802-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES CARE FOR ALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "MAHMUDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-802-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME93947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274846100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.