Individual
MICHELE CHRISTINA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 W DR MLK BLVD, TAMPA, FL 33607-6307
(813) 554-8527
(813) 554-8496
Mailing address
3001 W DR MLK BLVD, TAMPA, FL 33607-6307
(813) 554-8527
(813) 554-8496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9111363
FL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
PA9111363
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100322200
—
FL
Enumeration date
05/23/2018
Last updated
04/06/2023
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