Provider Demographics
NPI:1235119306
Name:DUPUY, GLADYS (DO)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:DUPUY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 RED RD
Mailing Address - Street 2:N404
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6013
Mailing Address - Country:US
Mailing Address - Phone:954-368-1308
Mailing Address - Fax:954-656-3224
Practice Address - Street 1:3600 RED RD
Practice Address - Street 2:# N404
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6013
Practice Address - Country:US
Practice Address - Phone:954-368-1308
Practice Address - Fax:954-589-0902
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8445207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL285085OtherAVMED
FL264574200Medicaid
FL44070AOtherBCBS
FLE7782YMedicare PIN
FL44070AOtherBCBS