Provider Demographics
NPI:1508859299
Name:GONZALEZ-COUVERTIER, GLENDA E (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:E
Last Name:GONZALEZ-COUVERTIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GLENDA
Other - Middle Name:E
Other - Last Name:GONZALEZ-CORTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2600 S DOUGLAS RD STE 308
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6134
Mailing Address - Country:US
Mailing Address - Phone:305-913-9454
Mailing Address - Fax:305-442-1198
Practice Address - Street 1:733 S GOLDENROD RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8100
Practice Address - Country:US
Practice Address - Phone:407-664-0515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076730207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267999000Medicaid
FL267999000Medicaid
G32727Medicare UPIN