| Doctor Name: | FIORELLA SVETLANA GLEN |
| NPI Number: | 1194002766 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 18340 |
| Business Practice Address: | 4400 W 12th Ln Hialeah, FL - 330125965 |
| Business Phone Number: | 7864167551 |
| Business Fax Number: | |
| Mailing Address: | 4400 W 12th Ln, HIALEAH |
| State: | FL |
| Postal Code: | 330125965 |
| Phone Number: | 7864167551 |
| Fax Number: | |
| NPI Enumeration Date: | 11/10/2011 |
| NPI Last Update Date: | 11/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18340 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |