Provider Demographics
NPI:1073524161
Name:GULATI & ASSOCIATES PA
Entity Type:Organization
Organization Name:GULATI & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-438-6080
Mailing Address - Street 1:10726 CHARLESTON PLACE
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:954-438-6080
Mailing Address - Fax:954-499-5599
Practice Address - Street 1:3105 N UNIVERSITY DR
Practice Address - Street 2:SUITE 209
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33024-2234
Practice Address - Country:US
Practice Address - Phone:954-438-6080
Practice Address - Fax:954-499-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 75667207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254728700Medicaid
FLED220AMedicare Oscar/Certification
G24783Medicare UPIN