Individual
TIA DANIELLE GLOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8925 COLONIAL CENTER DR STE 1000, FORT MYERS, FL 33905-7813
(239) 343-9560
(239) 343-9624
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9560
(239) 343-9624
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11006074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108307000
—
FL
Enumeration date
09/25/2020
Last updated
03/25/2021
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