Organization
COAST ORTHOPEDIC CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES D. GLENN M.D. (PHYSICIAN)
(321) 269-4300
Entity
Organization
Contact information
Practice address
1781 GARDEN ST, TITUSVILLE, FL 32796-3221
(321) 269-4300
(321) 269-7755
Mailing address
1781 GARDEN ST, TITUSVILLE, FL 32796-3221
(321) 269-4300
(321) 269-7755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME51090
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046402300
—
FL
Enumeration date
09/20/2006
Last updated
05/24/2016
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