Organization
ARIEL GASTROENTEROLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILSON NICOLAS OTERO M.D. (REGISTERED AGENT/GASTROENTEROLOGIST)
(954) 483-8422
Entity
Organization
Contact information
Practice address
7100 W 20TH AVE, SUITE 412, HIALEAH, FL 33016-1897
(305) 820-0006
(305) 828-6700
Mailing address
12400 SW 1ST CT, PLANTATION, FL 33325-2702
(954) 483-8335
(305) 828-6700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0044788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4073765
AETNA NETWORK PROVIDER ID
FL
Enumeration date
05/20/2008
Last updated
05/20/2008
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