Provider Demographics
NPI:1831570084
Name:GOGIA, PRANA (DAOM LAP)
Entity type:Individual
Prefix:DR
First Name:PRANA
Middle Name:
Last Name:GOGIA
Suffix:
Gender:M
Credentials:DAOM LAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 DIPLOMAT PKWY APT 204
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3707
Mailing Address - Country:US
Mailing Address - Phone:786-584-7726
Mailing Address - Fax:
Practice Address - Street 1:210 71ST ST STE 302
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3234
Practice Address - Country:US
Practice Address - Phone:786-584-7726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-13
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16634171100000X
FL4148171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist