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General NPI Number Information
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NPI Number | 1366989915
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Entity Type | Individual
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Provider Name | MRS. LINDSAY GLORIOSO
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Gender | Female
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 08/01/2018
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Provider Practice Location Address
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Address Line | 2020 59TH ST W
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City | BRADENTON
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State | FL
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Zip | 34209
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Country | US
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Telephone | 706-863-9595
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Fax | 706-868-8375
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Provider Business Mailing Address
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Address Line | PO BOX 3725
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City | AUGUSTA
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State | GA
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Zip | 30914-3725
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Country | US
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Telephone | 706-863-9595
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Fax | 706-868-8375
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9310021
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License Number State | FL
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