Individual
MR. GERALD GILBERT GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2901 SW 149TH AVE, SUITE 400, MIRAMAR, FL 33027-4151
(954) 874-4603
(954) 874-3261
Mailing address
2901 SW 149TH AVE, SUITE 400, MIRAMAR, FL 33027-4151
(954) 874-4603
(954) 874-3261
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3172
FL
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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