Clinical Gi and Hepatology Services LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

CLINICAL GI AND HEPATOLOGY SERVICES LLC

Practice address

1648 Derby Glen Dr
Orlando, FL 32837-8131

Phone

(407) 760-4598

NPI assigned

May 4, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Mahmudul Haq, M.D, MSCNPI 1619911146

Title

Owner

Phone

(407) 760-4598

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Mahmudul Haq, M.D.

  • Gastroenterology Physician
  • Orlando, FL
  • NPI 1619911146
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1972039345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 DERBY GLEN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378131",
            "telephone_number": "407-760-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 DERBY GLEN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378131",
            "telephone_number": "407-760-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL GI AND HEPATOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "HAQ",
        "authorized_official_first_name": "MAHMUDUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-760-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D, MSC"
    },
    "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": "BCBS",
            "identifier": "14LIJ",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109395700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.