Healthcare Provider Details

I. General information

NPI: 1972009967
Provider Name (Legal Business Name): GURINDER PAL SINGH GAKHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17240 CORTEZ BLVD
BROOKSVILLE FL
34601-8921
US

IV. Provider business mailing address

5450 BRUCE B DOWNS BLVD STE 341
WESLEY CHAPEL FL
33544-8616
US

V. Phone/Fax

Practice location:
  • Phone: 352-796-5111
  • Fax:
Mailing address:
  • Phone: 559-720-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA176700
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME162408
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: