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1760437883

NPI Code Detail

MEDICARE: GLENN A KWIAT MD

MEDICARE: GLENN A KWIAT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35.057132	OH
2	207Q00000X	Family Medicine Physician	ME100907	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00807421	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	53648	OTHER	FL	BLUE CROSS/BLUE SHIELD OF FLORIDA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760437883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENN A KWIAT MD

Provider Business Mailing Address
First Line	:	1428 PARILLA CIR
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-7052
Country	:	US
Telephone Number	:	727-207-7630
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 W GANDY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-2931
Country	:	US
Telephone Number	:	813-925-1903
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/27/2024

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Directions to “ GLENN A KWIAT MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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