Provider Demographics
NPI:1629306311
Name:GLASER FAMILY MEDICAL CENTER PLLC
Entity Type:Organization
Organization Name:GLASER FAMILY MEDICAL CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HERMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:813-643-9000
Mailing Address - Street 1:1017 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4886
Mailing Address - Country:US
Mailing Address - Phone:813-643-9000
Mailing Address - Fax:813-643-9001
Practice Address - Street 1:1017 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4886
Practice Address - Country:US
Practice Address - Phone:813-643-9000
Practice Address - Fax:813-643-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty