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General NPI Number Information
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NPI Number | 1427922335
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Entity Type | Individual
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Provider Name | PATRICIA A GLASS
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Gender | Female
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1320 LOUISIANA AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-4116
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Country | US
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Telephone | 407-593-0122
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Fax |
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Provider Business Mailing Address
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Address Line | 5020 JEAN ST
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City | COCOA
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State | FL
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Zip | 32927-9218
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Country | US
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Telephone | 831-801-8759
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Fax |
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 11042551
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License Number State | FL
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