Provider Demographics
NPI:1447207113
Name:GULATI, MOHAN S (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAN
Middle Name:S
Last Name:GULATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5484 SEA BISCUIT RD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-7811
Mailing Address - Country:US
Mailing Address - Phone:561-641-8787
Mailing Address - Fax:561-919-9108
Practice Address - Street 1:2401 PGA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3515
Practice Address - Country:US
Practice Address - Phone:561-641-8787
Practice Address - Fax:561-919-9108
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME699672081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32405Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION
FLG19618Medicare UPIN