Organization
WEST CENTRAL GASTROENTEROLOGY LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL PARR (CREDENTIALING SPECIALIST)
(727) 329-3371
Entity
Organization
Contact information
Practice address
3001 EXECUTIVE DR, SUITE 130, CLEARWATER, FL 33762-5323
(727) 347-0005
Mailing address
3001 EXECUTIVE DR, SUITE 130, CLEARWATER, FL 33762-5323
(727) 347-0005
(727) 541-6558
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
ND7225
FL
207RG0100X
Gastroenterology Physician
Primary
—
FL
207RI0008X
Hepatology Physician
ME68156
FL
207ZC0500X
Cytopathology Physician
OS4755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003J
BCBS
FL
05
—
001174000
—
FL
Enumeration date
05/12/2009
Last updated
09/28/2021
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