Individual
DR. GLENN BANEZ ZAIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2815 LAKELAND HILLS BLVD, LAKELAND, FL 33805-2224
(863) 284-6900
(863) 284-6904
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MEDICAL STAFF OFFICE, LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME111100
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/19/2010
Last updated
07/28/2022
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