Organization
MID FLORIDA GASTROENTEROLOGY CONSULTANTS LLC
Active
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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