Organization
GASTROENTEROLOGY CONSULTANTS OF POLK COUNTY PA
Active
Organization
GASTROENTEROLOGY CONSULTANTS OF POLK COUNTY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JATINDER DHALIWAL (MANAGER)
(863) 419-1166
Entity
Organization
Contact information
Practice address
40124 HWY 27, SUITE 102, DAVENPORT, FL 33837-5905
(863) 419-1166
(863) 419-1188
Mailing address
40124 HWY 27, SUITE 102, DAVENPORT, FL 33837-5905
(863) 419-1166
(863) 419-1188
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0069617
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379143200
—
FL
Enumeration date
09/13/2007
Last updated
04/15/2009
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