Provider Demographics
NPI:1497868418
Name:HAKKARAINEN, GLORIA C (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:C
Last Name:HAKKARAINEN
Suffix:
Gender:F
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:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0333
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:4671 S CONGRESS AVE
Practice Address - Street 2:SUITE 100 B
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-4783
Practice Address - Country:US
Practice Address - Phone:561-434-0111
Practice Address - Fax:561-296-3533
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73073207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256189100Medicaid
FLLN381OtherMEDICARE
FLG99455Medicare UPIN