Individual
DIVYANJALI GOPALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6181 N FEDERAL HWY, FORT LAUDERDALE, FL 33308-2227
(954) 493-6496
(954) 493-6726
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(954) 493-6496
(954) 493-6726
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
052271
CT
208000000X
Pediatrics Physician
Primary
ME141078
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104706100
—
FL
Enumeration date
07/05/2013
Last updated
11/20/2019
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