Basic Information
| Provider Information | |||||||||
| NPI: | 1891033791 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GLATTER | ||||||||
| FirstName: | CAROLE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608 SE 3RD AVE | ||||||||
| Address2: | THIRD FLOOR CBO/PBS | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548474572 | ||||||||
| FaxNumber: | 9548474176 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 S ANDREWS AVE | ||||||||
| Address2: | THIRD FLOOR | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544685276 | ||||||||
| FaxNumber: | 9547127990 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2013 | ||||||||
| LastUpdateDate: | 01/28/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WL0100X | RN1768382 | FL | Y | Nursing Service Providers | Registered Nurse | Lactation Consultant |
No ID Information.