Organization
MID-FLORIDA GASTROENTEROLOGY GROUP P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LENKALA REDDY MALLAIAH M.D. (PRESIDENT)
(407) 321-4570
Entity
Organization
Contact information
Practice address
311 N MANGOUSTINE AVE, SANFORD, FL 32771-1098
(407) 321-4570
(407) 321-7690
Mailing address
311 N MANGOUSTINE AVE, SANFORD, FL 32771-1098
(407) 321-4570
(407) 321-7690
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0037029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065414100
—
FL
01
—
110047015
RAILROAD MEDICARE
FL
01
—
77496
MEDICARE
—
01
—
CB7606
RAILROAD MEDICARE
FL
Enumeration date
12/21/2007
Last updated
09/20/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us