Provider Demographics
NPI:1851603948
Name:GLANSBERG, MARK STEVEN (MS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:STEVEN
Last Name:GLANSBERG
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4421 N 41ST CT
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1710
Mailing Address - Country:US
Mailing Address - Phone:954-295-2365
Mailing Address - Fax:
Practice Address - Street 1:4421 N 41ST CT
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1710
Practice Address - Country:US
Practice Address - Phone:954-295-2365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child