Individual
DR. DEAN RONALD GALLUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11380 SW VILLAGE PARKWAY#100, PORT SAINT LUCIE, FL 34987
(772) 301-6500
Mailing address
720 DUNLAWTON AVE # 200, PORT ORANGE, FL 32127-4901
(386) 202-7770
(386) 202-7771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS0004411
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115302000
—
FL
01
—
261083931
TAX ID
—
01
—
C10361
GROUP ORGANIZATION PTAN
—
01
—
DN2980
GROUP PTAN
—
01
—
P01309377
PTAN
—
Enumeration date
06/10/2006
Last updated
12/22/2025
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