Healthcare Provider Details

I. General information

NPI: 1780617977
Provider Name (Legal Business Name): GULAB SHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 HIGHLAND PARK BLVD SUITE D
LAKELAND FL
33813-1639
US

IV. Provider business mailing address

PO BOX 919424
ORLANDO FL
32891-9424
US

V. Phone/Fax

Practice location:
  • Phone: 863-816-5884
  • Fax: 863-940-4856
Mailing address:
  • Phone: 863-816-5884
  • Fax: 863-940-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME89483
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME89483
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: