1528243706 NPI number — GLORIA KEISER MSW PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528243706 NPI number — GLORIA KEISER MSW PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GLORIA KEISER MSW PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528243706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2855 N UNIVERSITY DR
Provider Second Line Business Mailing Address:
SUITE 530
Provider Business Mailing Address City Name:
CORAL SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33065-1410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-344-2697
Provider Business Mailing Address Fax Number:
954-344-5367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2855 N UNIVERSITY DR
Provider Second Line Business Practice Location Address:
SUITE 530
Provider Business Practice Location Address City Name:
CORAL SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33065-1410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-344-2697
Provider Business Practice Location Address Fax Number:
954-344-5367
Provider Enumeration Date:
01/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KEISER
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
LICENSED CLINICAL SOCIAL WORKER
Authorized Official Telephone Number:
954-803-3238

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  295 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1012614 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: Z145W . This is a "BLUE CROSS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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