Healthcare Provider Details

I. General information

NPI: 1356205850
Provider Name (Legal Business Name): GLADES MEDICAL CENTERS FOUNDATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91 NW 166TH ST BAY 77
NORTH MIAMI BEACH FL
33169-6013
US

IV. Provider business mailing address

91 NW 166TH ST BAY 77
NORTH MIAMI BEACH FL
33169-6013
US

V. Phone/Fax

Practice location:
  • Phone: 305-432-9565
  • Fax:
Mailing address:
  • Phone: 305-432-9565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BERNARD CASSIDY
Title or Position: PRESIDENT
Credential:
Phone: 786-317-2377