NURSING HOME PHYSICIAN NPI 1396769725

NPI Information

NPI: 1396769725
Provider Name: NURSING HOME PHYSICIAN

Doing Business As: GLENN GIDSEG

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
8091 MIZNER LN
BOCA RATON, FL
ZIP 33433
Phone: (561) 289-4642
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NURSING HOME PHYSICIAN is a family nurse practitioner in Boca Raton, FL. NURSING HOME PHYSICIAN NPI is 1396769725. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Glenn Gidseg.

The provider's business location address is:

8091 MIZNER LN
BOCA RATON, FL
ZIP 33433-127
Phone: (561) 289-4642

The provider's authorized official is Glenn Gidseg .
The authorized official title is President and has the following contact phone number (954) 363-1011.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 9/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	759965	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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