Provider Demographics
NPI:1831174499
Name:SINGER, GLENN R (MD)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:R
Last Name:SINGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:255 SE 14TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316
Mailing Address - Country:US
Mailing Address - Phone:954-467-8266
Mailing Address - Fax:954-467-4137
Practice Address - Street 1:255 SE 14TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316
Practice Address - Country:US
Practice Address - Phone:954-467-8266
Practice Address - Fax:954-467-4137
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2013-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME36506207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068059100Medicaid
D64683Medicare UPIN
FL068059100Medicaid