Individual
TODD F GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S. ORANGE AVE., SUITE 100, NEMOURS CHILDREN'S CLINIC, ORLANDO, ORLANDO, FL 32806-2946
(407) 650-7715
(407) 650-7124
Mailing address
P.O. BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 298-7371
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
ME111854
FL
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35-07-4850
OH
Other
Enumeration date
06/29/2006
Last updated
04/06/2012
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