Provider Demographics
NPI:1003110669
Name:GLASSMAN, BARRY M (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:M
Last Name:GLASSMAN
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 1:2451 NE 199TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1829
Mailing Address - Country:US
Mailing Address - Phone:305-932-7403
Mailing Address - Fax:305-935-3725
Practice Address - Street 1:2451 NE 199TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1829
Practice Address - Country:US
Practice Address - Phone:305-932-7403
Practice Address - Fax:305-935-3725
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00122832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58124Medicare UPIN