Provider Demographics
NPI:1407095615
Name:GADH, RUNDEEP SINGH (DO)
Entity Type:Individual
Prefix:DR
First Name:RUNDEEP
Middle Name:SINGH
Last Name:GADH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:RICK
Other - Middle Name:SINGH
Other - Last Name:GADH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:4780 SW 64TH AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4400
Mailing Address - Country:US
Mailing Address - Phone:954-434-1705
Mailing Address - Fax:
Practice Address - Street 1:600 S PINE ISLAND RD STE 104
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-474-4401
Practice Address - Fax:954-474-9883
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS10350OtherMEDICAL LICENSE