Individual
ADAM RYAN GLASSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12303 SAN JOSE BLVD, JACKSONVILLE, FL 32223-2640
(904) 288-0277
Mailing address
570 STERNWHEEL DR, ST JOHNS, FL 32259-8662
(540) 460-4236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105842
FL
363AS0400X
Surgical Physician Assistant
022420
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003323800
—
FL
Enumeration date
01/06/2011
Last updated
08/19/2020
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