Provider Demographics
NPI:1245617398
Name:GLADYS DUPUY, PA
Entity Type:Organization
Organization Name:GLADYS DUPUY, PA
Other - Org Name:ORCHID OB/GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPUY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-772-8562
Mailing Address - Street 1:3600 RED RD
Mailing Address - Street 2:SUITE N 404
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:SUITE N 404
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:954-656-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8445207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264574200Medicaid
FLH66528Medicare UPIN
FL264574200Medicaid