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General NPI Number Information
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NPI Number | 1336118017
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Entity Type | Individual
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Provider Name | ALEXANDER M GORUP MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 1601 CLINT MOORE RD STE 105
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City | BOCA RATON
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State | FL
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Zip | 33487-5712
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Country | US
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Telephone | 561-391-3333
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Fax | 561-391-5618
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Provider Business Mailing Address
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Address Line | 1601 CLINT MOORE RD STE 215
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City | BOCA RATON
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State | FL
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Zip | 33487-5716
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Country | US
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Telephone | 561-939-0193
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Fax | 561-338-6271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01058318A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 01058318A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME112703
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License Number State | FL
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