CANDACE JORDAN GLENN (NPI# 1154681039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154681039 |
| Entity Type | Individual |
| Full Name | CANDACE JORDAN GLENN |
| Credential | M.D. |
| Practice Address |
4037 Nw 86th Ter Fl 4 Gainesville FL 32606-9277 |
| Practice Telephone | 3525941500 |
| Practice Fax Number | 3525941926 |
| Mailing Telephone | 3525941500 |
| Mailing Fax Number | 3525941926 |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2014-01-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | TRN17317 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4037 NW 86TH TER FL 4 |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32606-9277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053602128 | Vlatka Agnetta | Dermatology | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2011-04-25 |
| 1154881589 | Tyler Werbel | Student in an Organized Health Care Education/Training Program | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2019-03-21 |
| 1952806531 | Penelope Kallis | Student in an Organized Health Care Education/Training Program | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2018-03-27 |
| 1770088379 | Elizabeth Louise Bisbee | Student in an Organized Health Care Education/Training Program | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2018-03-26 |
| 1134515752 | Nicole Reusser Bender | Dermatology | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2015-04-09 |
| 1598179277 | Leah Hooey | Dermatology | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2014-06-20 |
| 1952655185 | Domina Nyinawinyange | Physician Assistant | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2012-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326652389 | Michael James Watkins | Massage Therapist | 6418 Nw 39th Ave, Gainesville, FL 32606 | 2020-09-06 |
| 1073134813 | Sun View Counseling LLC | Counselor | 3550 Nw 87 Ter., Gainesville, FL 32606 | 2020-05-04 |
| 1588283568 | Jeena Kar | Student in an Organized Health Care Education/Training Program | Uf Psychiatry Residency Training, 4101 Nw 89th Boulevard, Rm 1796, Gainesville, FL 32606 | 2020-04-10 |
| 1467917864 | Marquetta Lee | Social Worker | 2772 Nw 43rd St, Ste C, Gainesville, FL 32606 | 2019-02-10 |
| 1376025742 | Jacob Sanow | Student in an Organized Health Care Education/Training Program | 5200 Nw 43rd St Unit 401, Gainesville, FL 32606 | 2018-09-03 |
| 1750878393 | Taylor Brown | Occupational Therapist | 3850 Nw 83rd St # 201, Gainesville, FL 32606 | 2018-04-19 |
| 1568914471 | Bernard Mitchll | Behavior Technician | 3515 Nw 60th Terrace, Gainesville, FL 32606 | 2016-10-26 |
| 1760839534 | Nancy Christiana Collins | Counselor | 4907 Nw 43rd St C., Gainesville, FL 32606 | 2016-05-20 |
| 1730553140 | Dawn Johnson O'byrne | Counselor | 4041 Nw 37th Place, Suite A, Gainesville, FL 32606 | 2015-11-23 |
| 1225424815 | Dianne Voitle | Acupuncturist | 2727b N.w. 43rd St. Suite 8, Gainesville, FL 32606 | 2015-04-09 |
| Find all providers in zip 32606 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053602128 | Vlatka Agnetta | Dermatology | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2011-04-25 |
| 1245521251 | Marjorie E Montanez-wiscovich | Dermatology | 1600 Sw Archer Rd # 100279, Gainesville, FL 32610-3003 | 2011-04-25 |
| 1104051515 | Sailesh Konda | Dermatology | 4037 Nw 86th Ter, 4th Floor, Gainesville, FL 32606-9277 | 2009-05-29 |
| 1104081322 | Reena Moza Vaid | Dermatology | 7500 Gardner Park Dr, Gainesville, VA 20155-3414 | 2008-07-28 |
| 1972708329 | Daven Navnit Doshi | Dermatology | 4525 Sw 13th St, Gainesville, FL 32608-3901 | 2007-06-17 |
| 1821157116 | Dermatology Associates Ne Ga | Dermatology | 974 South Enota Drive Ne, Gainesville, GA 30501 | 2006-12-06 |
| 1275628562 | Betsy B Beers | Dermatology | 350 Nw 76 Drive, Suite A, Gainesville, FL 32607 | 2006-10-04 |
| 1861504516 | Ruth C Wilkerson | Dermatology | 4850 Sw 91 Terrace, Ste P 102, Gainesville, FL 32608-6038 | 2006-08-31 |
| 1598787756 | Kurt Laurence Maggio | Dermatology | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2006-07-24 |
| 1437109899 | Lanier Dermatology & Skin Cancer Specialists, PC | Dermatology | 605 S Enota Dr Ne, Gainesville, GA 30501-2437 | 2006-05-10 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32606 |
Please comment or provide details below to improve the information on CANDACE JORDAN GLENN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.