Organization
GASTRO GROUP OF THE PALM BEACHES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA BOLOGNINI (CHIEF OPERATING OFFICER)
(561) 659-6632
Entity
Organization
Contact information
Practice address
3401 PGA BLVD STE 500, PALM BEACH GARDENS, FL 33410-2825
(561) 659-6543
(561) 659-3533
Mailing address
3401 PGA BLVD STE 500, PALM BEACH GARDENS, FL 33410-2825
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002990900
—
FL
Enumeration date
09/23/2010
Last updated
02/14/2025
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