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General NPI Number Information
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NPI Number | 1700828431
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Entity Type | Individual
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Provider Name | DEAN RONALD GALLUPE D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 11380 SW VILLAGE PARKWAY#100
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987
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Country | US
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Telephone | 772-301-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 720 DUNLAWTON AVE # 200
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City | PORT ORANGE
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State | FL
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Zip | 32127-4901
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Country | US
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Telephone | 386-202-7770
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Fax | 386-202-7771
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0004411
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License Number State | FL
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