Individual
BENJAMIN RICHARD GLIDDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
8700 ESTRADA ST, NAVARRE, FL 32566-2181
(850) 496-6868
Mailing address
8700 ESTRADA ST, NAVARRE, FL 32566-2181
(850) 496-6868
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9339925
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11015956
FL
363LG0600X
Gerontology Nurse Practitioner
APRN11015956
FL
Other
Enumeration date
09/16/2021
Last updated
11/02/2021
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