Provider Demographics
NPI:1063505816
Name:GAUS, VICTORIA MACATANGAY (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MACATANGAY
Last Name:GAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 EAST COMMERCIAL BOULEVARD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-431-8022
Mailing Address - Fax:954-431-8078
Practice Address - Street 1:2151 EAST COMMERCIAL BOULEVARD
Practice Address - Street 2:SUITE 202
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-431-8022
Practice Address - Fax:954-431-8078
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97569208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation