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General NPI Number Information
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NPI Number | 1144849738
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Entity Type | Organization
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Legal Business Name | CENTER FOR NEUROSURGERY(GLICKMAN) PLLC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 42 BUSINESS CENTRE DR UNIT 310
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-6995
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Country | US
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Telephone | 850-803-2672
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Fax | 850-600-2675
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Provider Business Mailing Address
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Address Line | 42 BUSINESS CENTRE DR UNIT 310
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-6995
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Country | US
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Telephone | 850-803-2672
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Fax | 850-600-2675
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | SCOTT GARY GLICKMAN
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Credential |
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Telephone | 850-803-2672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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