Healthcare Provider Details

I. General information

NPI: 1780761015
Provider Name (Legal Business Name): DAPHNE GLEIT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1865 S OCEAN DR APT 11A
HALLANDALE BEACH FL
33009-7604
US

IV. Provider business mailing address

1865 S OCEAN DR APT 11A
HALLANDALE BEACH FL
33009-7604
US

V. Phone/Fax

Practice location:
  • Phone: 631-748-5488
  • Fax:
Mailing address:
  • Phone: 631-748-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number163339
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number188723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: