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Organization

MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOHAMMAD REZA MASTALI M.D. (OWNER)
(407) 822-1171
Entity
Organization

Contact information

Practice address
10000 W COLONIAL DR STE 389, OCOEE, FL 34761-3433
(407) 822-1171
(407) 822-1172
Mailing address
10000 W COLONIAL DR STE 389, OCOEE, FL 34761-3433
(407) 822-1171
(407) 822-1172

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1689762924
INDIVIDUAL NPI #
FL
Enumeration date
10/11/2006
Last updated
04/13/2011
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