Mid Florida Gastroenterology Consultants LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC

Practice address

10000 W Colonial Dr Ste 389
Ocoee, FL 34761-3433

Phone

(407) 822-1171

Fax

(407) 822-1172

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mohammad Reza Mastali, M.D.

Title

Owner

Phone

(407) 822-1171

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302652800000",
    "number": "1740378009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 389",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613433",
            "telephone_number": "407-822-1171",
            "fax_number": "407-822-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W COLONIAL DR STE 389",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613433",
            "telephone_number": "407-822-1171",
            "fax_number": "407-822-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2011-04-13",
        "status": "A",
        "authorized_official_last_name": "MASTALI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-822-1171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1689762924",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon C Merrill
• Chloe Merrow
• Beshoy Michael, PHARMD
• Marie Natacha Michel, RBT
• Michelle Dan El Carr Inc
• Adrijana Mijatovic, NP
• Kerolus Mikhail
• Chrisline Milard
• Katrina Milian
• David R Miller, LMHC

• Gastroenterology Physician in Ocoee, FL
• Providers in Ocoee, 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 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.