Provider Demographics
NPI:1336195403
Name:GLOSSER, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:GLOSSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:941 N KROME AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4408
Mailing Address - Country:US
Mailing Address - Phone:305-248-6311
Mailing Address - Fax:305-242-5559
Practice Address - Street 1:941 N KROME AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4408
Practice Address - Country:US
Practice Address - Phone:305-248-6311
Practice Address - Fax:305-242-5559
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0051532207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000972100Medicaid
FL000972100Medicaid
FLB84884Medicare UPIN