Provider Demographics
NPI:1962843623
Name:IMAGES OF GLORY, INC
Entity type:Organization
Organization Name:IMAGES OF GLORY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:NORFLEET
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:321-972-2910
Mailing Address - Street 1:PO BOX 623186
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32762-3186
Mailing Address - Country:US
Mailing Address - Phone:321-972-2910
Mailing Address - Fax:321-244-0253
Practice Address - Street 1:7480 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9102
Practice Address - Country:US
Practice Address - Phone:407-988-3048
Practice Address - Fax:407-573-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service