| NPI | 1740045004 |
|---|---|
| Former Legal Business Name | DIANA SOFIA GLACCUM-GAVAGNI, MD, PA |
| Entity Type | Organization |
| Authorized Contact | DIANA SOFIA GLACCUM-GAVAGNI Owner/Psychiatrist 954-546-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-02-15 |
| Last Update Date | 2024-02-15 |