Provider Demographics
NPI:1679556864
Name:DOCTORS GI PARTNERSHIP LTD
Entity type:Organization
Organization Name:DOCTORS GI PARTNERSHIP LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP CFO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-315-3569
Mailing Address - Street 1:PO BOX 562767
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32956-2767
Mailing Address - Country:US
Mailing Address - Phone:321-434-5491
Mailing Address - Fax:321-434-5419
Practice Address - Street 1:5191 BABCOCK ST NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4610
Practice Address - Country:US
Practice Address - Phone:321-434-1919
Practice Address - Fax:321-434-5419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1133261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075479000Medicaid
FL7136337OtherAETNA
FL490005411OtherRAILROAD MEDICARE
FL6A6OtherBLUE CROSS
FL490005411OtherRAILROAD MEDICARE