Basic Information
| Provider Information | |||||||||
| NPI: | 1992941868 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ADVANCE GASTROENTEROLOGY AND PULMONARY CARE PL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7128 SAGHEER ST | ||||||||
| Address2: | |||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346136535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523454876 | ||||||||
| FaxNumber: | 3523454880 | ||||||||
| Practice Location | |||||||||
| Address1: | 7128 SAGHEER ST | ||||||||
| Address2: | |||||||||
| City: | BROOKSVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346136535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3523454876 | ||||||||
| FaxNumber: | 3523454880 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2008 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| AuthorizedOfficialLastName: | BIN-SAGHEER | ||||||||
| AuthorizedOfficialFirstName: | SYED | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3523454876 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | ME70282 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RP1001X | ME103045 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RG0100X | ME70282 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.