Provider Demographics
NPI:1235118399
Name:GADH, KOMPAL (MD)
Entity Type:Individual
Prefix:
First Name:KOMPAL
Middle Name:
Last Name:GADH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KOMPAL
Other - Middle Name:
Other - Last Name:GADH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 432040
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33243-2040
Mailing Address - Country:US
Mailing Address - Phone:954-499-4570
Mailing Address - Fax:954-889-0027
Practice Address - Street 1:601 N. FLAMINGO RD.
Practice Address - Street 2:STE 307
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-499-4570
Practice Address - Fax:954-889-0027
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92596207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16145OtherBCBS
FL273007300Medicaid
FL16145XMedicare PIN
FL16145OtherBCBS
FL16145YMedicare PIN
FL273007300Medicaid
FL16145ZMedicare PIN
FL16145VMedicare PIN