Doctor Name: | MR. CLARKE GLATT |
NPI Number: | 1154595593 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | DO1580 |
Business Practice Address: | 612 S Hunt Club Blvd Apopka, FL - 327034958 |
Business Phone Number: | 4078622020 |
Business Fax Number: | 4078626730 |
Mailing Address: | 612 S Hunt Club Blvd, APOPKA |
State: | FL |
Postal Code: | 327034958 |
Phone Number: | 4078622020 |
Fax Number: | 4078626730 |
NPI Enumeration Date: | 04/16/2008 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | DO1580 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |