Provider Demographics
NPI:1821089764
Name:GHULLDU, HARBINDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARBINDER
Middle Name:SINGH
Last Name:GHULLDU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 TURKEY LAKE RD
Mailing Address - Street 2:SUITE 1-1
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7218
Mailing Address - Country:US
Mailing Address - Phone:407-370-9783
Mailing Address - Fax:407-370-9784
Practice Address - Street 1:6900 TURKEY LAKE RD
Practice Address - Street 2:SUITE 1-1
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7218
Practice Address - Country:US
Practice Address - Phone:407-370-9783
Practice Address - Fax:407-370-9784
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75691207R00000X, 207RS0012X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260890100Medicaid
FL35662AMedicare ID - Type Unspecified
FLG13938Medicare UPIN