Provider Demographics
NPI:1922006196
Name:GLATZER, RONALD J (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:GLATZER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 39209
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33339
Mailing Address - Country:US
Mailing Address - Phone:954-851-9966
Mailing Address - Fax:954-318-7360
Practice Address - Street 1:1930 NE 47 STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7704
Practice Address - Country:US
Practice Address - Phone:954-772-3337
Practice Address - Fax:561-498-8188
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2021-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME15921207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050033000Medicaid
FL050033000Medicaid
FL71613Medicare PIN