Provider Demographics
NPI:1669899951
Name:GLADSTONE, AMY (MS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:GLADSTONE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:UNIVERSITY OF FLORIDA
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0001
Mailing Address - Country:US
Mailing Address - Phone:352-294-5050
Mailing Address - Fax:352-392-3051
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:UNIVERSITY OF FLORIDA
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0001
Practice Address - Country:US
Practice Address - Phone:352-294-5050
Practice Address - Fax:352-392-3051
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS