Provider Demographics
NPI:1205284288
Name:GULATI, ABHISHEK (DO)
Entity type:Individual
Prefix:DR
First Name:ABHISHEK
Middle Name:
Last Name:GULATI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6057 MAIDENSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-2281
Mailing Address - Country:US
Mailing Address - Phone:805-166-6564
Mailing Address - Fax:
Practice Address - Street 1:3930 8TH AVE W FL 34205
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1702
Practice Address - Country:US
Practice Address - Phone:941-708-9421
Practice Address - Fax:941-708-9424
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS16046207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS16046OtherLICENSE