Provider Demographics
NPI:1972847960
Name:BESS, GLORIA S
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:S
Last Name:BESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 BLUE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32443-2066
Mailing Address - Country:US
Mailing Address - Phone:850-272-0703
Mailing Address - Fax:
Practice Address - Street 1:5704 BLUE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:FL
Practice Address - Zip Code:32443-2066
Practice Address - Country:US
Practice Address - Phone:850-272-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health