Provider Demographics
NPI:1225239478
Name:GUGOL, RUBEE ANNE DELEON (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBEE ANNE
Middle Name:DELEON
Last Name:GUGOL
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 1:2005 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4139
Mailing Address - Country:US
Mailing Address - Phone:337-562-2293
Mailing Address - Fax:337-562-0765
Practice Address - Street 1:2005 SOUTHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4139
Practice Address - Country:US
Practice Address - Phone:337-562-2293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 8549390200000X
LAMD.2030752080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program