Provider Demographics
NPI:1780761015
Name:GLEIT, DAPHNE (MD)
Entity type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:
Last Name:GLEIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 S OCEAN DR APT 11A
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7604
Mailing Address - Country:US
Mailing Address - Phone:631-748-5488
Mailing Address - Fax:
Practice Address - Street 1:1865 S OCEAN DR APT 11A
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7604
Practice Address - Country:US
Practice Address - Phone:631-748-5488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163339208000000X
NY188723208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01695725Medicaid