Individual
JEIMY P GLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5850 CORAL RIDGE DR, CORAL SPRINGS, FL 33076-3378
(954) 714-8200
Mailing address
5850 CORAL RIDGE DR STE 106, CORAL SPRINGS, FL 33076-3379
(954) 714-8200
(954) 840-2626
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAT9110698
FL
363AM0700X
Medical Physician Assistant
PAT9110698
FL
363AS0400X
Surgical Physician Assistant
PAT9110698
FL
Other
Enumeration date
09/26/2017
Last updated
07/21/2022
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