MEDICARE: HERMANDA GLASER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME94379	FL

General Provider Information

NPI Number	:	1114984689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERMANDA GLASER M.D.

Provider Business Mailing Address
First Line	:	7365 MERCHANT CT STE 1
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8446
Country	:	US
Telephone Number	:	941-362-2744
Fax Number	:	941-362-2745

Provider Business Practice Location Address
First Line	:	7365 MERCHANT CT STE 1
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34240-8446
Country	:	US
Telephone Number	:	941-362-2744
Fax Number	:	941-362-2745

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	04/16/2021

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Directions to “ HERMANDA GLASER M.D.” Practice Location

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