Provider Demographics
NPI:1396734539
Name:GLASSER, HARVEY ALLEN (MD)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:ALLEN
Last Name:GLASSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19195 MYSTIC POINT DRIVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180
Mailing Address - Country:US
Mailing Address - Phone:305-936-0230
Mailing Address - Fax:305-936-0230
Practice Address - Street 1:19195 MYSTIC POINT DRIVE
Practice Address - Street 2:SUITE 408
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180
Practice Address - Country:US
Practice Address - Phone:305-936-0230
Practice Address - Fax:305-936-0230
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12061207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D65622Medicare UPIN