Healthcare Provider Details

I. General information

NPI: 1962450783
Provider Name (Legal Business Name): DEBORAH ZIPIN GLICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 GOODLETTE RD NORTH STE 200
NAPLES FL
34102-5644
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 239-231-7260
  • Fax: 239-947-5298
Mailing address:
  • Phone: 855-963-2100
  • Fax: 813-976-7823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME87155
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME87155
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: