Provider Demographics
NPI:1285991109
Name:GLENN H. ENGLANDER, M.D., P.A.
Entity type:Organization
Organization Name:GLENN H. ENGLANDER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:ENGLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-832-2465
Mailing Address - Street 1:1411 N FLAGLER DR STE 8700
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3421
Mailing Address - Country:US
Mailing Address - Phone:561-832-2465
Mailing Address - Fax:561-832-2818
Practice Address - Street 1:1411 N FLAGLER DR STE 8700
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3421
Practice Address - Country:US
Practice Address - Phone:561-832-2465
Practice Address - Fax:561-832-2818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59925207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGA831AMedicare PIN
FLA60066Medicare UPIN