Provider Demographics
NPI:1477580165
Name:GLICK, ARTHUR (APRN)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:GLICK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:ARTHUR
Other - Middle Name:
Other - Last Name:GLICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2010 NW 150TH AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2888
Mailing Address - Country:US
Mailing Address - Phone:954-431-9838
Mailing Address - Fax:954-241-6726
Practice Address - Street 1:2010 NW 150TH AVE
Practice Address - Street 2:STE 120
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-2888
Practice Address - Country:US
Practice Address - Phone:954-431-9838
Practice Address - Fax:954-241-6726
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303765363LA2200X
FLAPRN9240690363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02574532Medicaid