Provider Demographics
NPI:1295083657
Name:GLENN R. SINGER, MD, PA
Entity type:Organization
Organization Name:GLENN R. SINGER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-467-8266
Mailing Address - Street 1:255 SE 14TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316
Mailing Address - Country:US
Mailing Address - Phone:954-467-8266
Mailing Address - Fax:954-467-4137
Practice Address - Street 1:255 SE 14TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316
Practice Address - Country:US
Practice Address - Phone:954-467-8266
Practice Address - Fax:954-467-4137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36506207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068059100Medicaid
FLD64683Medicare UPIN