Organization
GASTROENTEROLOGY ASSOCIATES OF VENICE & ENGLEWOOD P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARIQ J KHAN MD (MD PRESIDENT)
(941) 412-9787
Entity
Organization
Contact information
Practice address
8421 POINTE LOOP DR, VENICE, FL 34293-2232
(941) 412-9787
(941) 480-0388
Mailing address
PO BOX 1764, VENICE, FL 34284-1764
(941) 412-9787
(941) 480-0388
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME57290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34112
BLUE CROSS
FL
01
—
7370390
AETNA
FL
01
—
CJ5399
RAILROAD MEDICARE
FL
Enumeration date
08/11/2006
Last updated
08/22/2020
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