Provider Demographics
NPI:1023140308
Name:RICHARD L GLATZER MD PA
Entity type:Organization
Organization Name:RICHARD L GLATZER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:GLATZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-279-9511
Mailing Address - Street 1:8525 SW 92 ST
Mailing Address - Street 2:SUITE C11A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156
Mailing Address - Country:US
Mailing Address - Phone:305-279-9511
Mailing Address - Fax:305-274-3686
Practice Address - Street 1:8525 SW 92 ST
Practice Address - Street 2:SUITE C11A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-279-9511
Practice Address - Fax:305-274-3686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL01665207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D52283Medicare UPIN