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Organization

GASTROENTEROLOGY GROUP OF THE PALM BEACHES, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LISA BOLOGNINI (ADMINISTRATIVE DIRECTOR)
(561) 659-6632
Entity
Organization

Contact information

Practice address
2001 N FLAGLER DR, WEST PALM BEACH, FL 33407-6109
(561) 659-6543
(561) 659-3533
Mailing address
2001 N FLAGLER DR, WEST PALM BEACH, FL 33407-6109
(561) 659-6543
(561) 659-3533

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0043419
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
042147200
FL
Enumeration date
06/17/2005
Last updated
11/30/2009
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