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General NPI Number Information
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NPI Number | 1750519393
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Entity Type | Organization
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Legal Business Name | GLENN A ALTMAN OD PA
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 2936 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-2412
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Country | US
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Telephone | 941-351-2218
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Fax | 941-359-8950
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Provider Business Mailing Address
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Address Line | 2936 UNIVERSITY PKWY
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City | SARASOTA
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State | FL
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Zip | 34243-2412
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Country | US
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Telephone | 941-351-2218
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Fax | 941-359-8950
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Authorized Official
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Title or Position | PSDT
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Name | DR. GLENN ALAN ALTMAN
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Credential | OD
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Telephone | 941-351-2218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC2688
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License Number State | FL
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