Organization
INVALID NPI
Active
Organization
INVALID NPI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA M COOK (DIRECTOR OF BUSINESS OPERATIONS)
(850) 769-0329
Entity
Organization
Contact information
Practice address
801 E 6TH ST, SUITE 504, PANAMA CITY, FL 32401-3661
(850) 769-0329
Mailing address
801 E 6TH ST, SUITE 504, PANAMA CITY, FL 32401-3661
(850) 769-0329
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
10/14/2014
Last updated
04/02/2024
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