Healthcare Provider Details

I. General information

NPI: 1912836982
Provider Name (Legal Business Name): G SARLIS GROUP INC DBA SELF360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NW 70TH AVE STE 10
PLANTATION FL
33317-2911
US

IV. Provider business mailing address

150 NW 70TH AVE STE 10
PLANTATION FL
33317-2911
US

V. Phone/Fax

Practice location:
  • Phone: 954-302-4373
  • Fax:
Mailing address:
  • Phone: 954-302-4373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GLENDA SARLI
Title or Position: OWNER
Credential: DNP, FNP-BC
Phone: 786-252-3353