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Individual

GLADYS AMELIA SUMMERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PBT

Contact information

Practice address
2614 SE 19TH CT, HOMESTEAD, FL 33035-1300
(813) 409-5796
Mailing address
2614 SE 19TH CT, HOMESTEAD, FL 33035-1300
(813) 409-5796

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
1407521097
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407522097
OTHER
FL
Enumeration date
08/23/2021
Last updated
10/13/2021
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