Basic Information
| Provider Information | |||||||||
| NPI: | 1841502861 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GI DOCS S FLORIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 740177 | ||||||||
| Address2: | |||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334740177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617322900 | ||||||||
| FaxNumber: | 5617402901 | ||||||||
| Practice Location | |||||||||
| Address1: | 1325 S CONGRESS AVE | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334265876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617322900 | ||||||||
| FaxNumber: | 5617402901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 07/07/2010 | ||||||||
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| AuthorizedOfficialLastName: | HORVATH | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5617322900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.