Glaccum-Gavagni, Diana Sofia

Glaccum-Gavagni, Diana Sofia is an individual health care provider with primary practice located at 900 Sw 196Th Ave , Pembroke Pines FL 33029-1329. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Glaccum-Gavagni, Diana Sofia can be contacted via phone (954) 546-2707.

Contact Information

Primary practice address
900 Sw 196Th Ave Pembroke Pines FL 33029-1329
Phone: (954) 546-2707
Fax: (305) 355-7195
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME105239 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME105239 Florida

Profile Details

NPI number 1801097001
LBN Legal business name Glaccum-Gavagni, Diana Sofia
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Mar 28th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801097001 NPPES
Florida MEDICAID 001754800

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