Provider Demographics
NPI:1457336323
Name:GLASER, CHARLES ISRAEL (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ISRAEL
Last Name:GLASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CHARLES
Other - Middle Name:I
Other - Last Name:GLASER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7495 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2971
Mailing Address - Country:US
Mailing Address - Phone:954-722-2300
Mailing Address - Fax:954-720-7493
Practice Address - Street 1:7101 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5351
Practice Address - Country:US
Practice Address - Phone:954-722-5600
Practice Address - Fax:954-674-4528
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0013981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06994XMedicare ID - Type UnspecifiedPROVIDER NUMBER
D51822Medicare UPIN