Provider Demographics
NPI:1689152902
Name:TALDIBAEVA-PUGLIESE, GULNARA (MD)
Entity type:Individual
Prefix:DR
First Name:GULNARA
Middle Name:
Last Name:TALDIBAEVA-PUGLIESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6100 BLUE LAGOON DR STE 365
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-7010
Mailing Address - Country:US
Mailing Address - Phone:786-322-7333
Mailing Address - Fax:786-347-5022
Practice Address - Street 1:2416 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5720
Practice Address - Country:US
Practice Address - Phone:954-779-5610
Practice Address - Fax:954-302-2420
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME153132207R00000X, 207R00000X
PR34200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine