Organization
ADVANCED GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMMAR HUMAIDEN (CEO)
(386) 763-4939
Entity
Organization
Contact information
Practice address
1690 DUNLAWTON AVE, PORT ORANGE, FL 32127-8979
(386) 763-4920
Mailing address
1690 DUNLAWTON AVE., PORT ORANGE, FL 32127-8979
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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