Healthcare Provider Details

I. General information

NPI: 1407454069
Provider Name (Legal Business Name): GAYATRI MULDEO MSN, APRN, FNC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15035 MICHELANGELO BLVD APT 303
DELRAY BEACH FL
33446-2898
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 352-426-1066
  • Fax:
Mailing address:
  • Phone: 239-432-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11006270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: