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Individual

JORGE N GLASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1348 S 18TH ST STE 210, FERNANDINA BEACH, FL 32034-4785
(904) 261-9108
(904) 261-9911
Mailing address
PO BOX 2462, SALT LAKE CITY, UT 84110-2462
(904) 202-1032
(904) 376-4107

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME143190
FL
207RP1001X
Pulmonary Disease Physician
50609
TN
207RP1001X
Pulmonary Disease Physician
66607
GA
207RP1001X
Pulmonary Disease Physician
Primary
ME143190
FL

Other

Enumeration date
03/10/2006
Last updated
02/12/2020
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