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General NPI Number Information
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NPI Number | 1619123445
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Entity Type | Organization
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Legal Business Name | RONALD S. GUP, MD, PA
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 4060 SHERIDAN ST SUITE B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3559
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Country | US
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Telephone | 954-966-9001
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Fax | 954-985-0456
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Provider Business Mailing Address
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Address Line | 4060 SHERIDAN ST SUITE B
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3559
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Country | US
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Telephone | 954-966-9001
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Fax | 954-985-0456
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. RONALD S GUP
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Credential | MD
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Telephone | 954-966-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 44479
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License Number State | FL
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