Provider Demographics
NPI:1932255361
Name:GLORIA FARINA MD PA
Entity Type:Organization
Organization Name:GLORIA FARINA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-778-9991
Mailing Address - Street 1:370 17TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5690
Mailing Address - Country:US
Mailing Address - Phone:772-778-9991
Mailing Address - Fax:772-778-3833
Practice Address - Street 1:370 17TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5690
Practice Address - Country:US
Practice Address - Phone:772-778-9991
Practice Address - Fax:772-778-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K5381Medicare ID - Type Unspecified