MEDICARE: GLORIA EMULUT

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	101YM0800X	Mental Health Counselor	MH19351	FL

General Provider Information

NPI Number	:	1225971799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA EMULUT

Provider Business Mailing Address
First Line	:	31918 US 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3730
Country	:	US
Telephone Number	:	727-451-7481
Fax Number	:

Provider Business Practice Location Address
First Line	:	31918 US 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3730
Country	:	US
Telephone Number	:	727-451-7481
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Practice Location Address:

31918 US 19 N
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1538282454 — MR. DOMINIC JOSEPH INTRAVAIA DPT
Practice Location Address:

31964 US HIGHWAY 19 N
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1043413180 — DR. JOHN A TUTAY DMD
Practice Location Address:

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1548401557 — MR. CHRISTOPHER THOMAS CLARKE LMT
Practice Location Address:

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Directions to “ GLORIA EMULUT ” Practice Location

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