DR. DIANA SOFIA GLACCUM-GAVAGNI, M.D.
Psychiatric at 12 Ave, Miami, FL

License number
Florida TRN9234
Category
Student, Health Care
Type
Student in an Organized Health Care Education/Training Program
License number
Florida ME105239
Category
Psychiatric
Type
Psychiatry
Address
Address
1611 NW 12Th Ave, Miami, FL 33136
Phone
(305) 355-7066
(305) 355-7195 (Fax)
(305) 573-8646
National Provider ID: 1801097001
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about DIANA SOFIA GLACCUM-GAVAGNI at bizstanding.com

Diana Sofia Glaccum-Gavagni MD, PA

Miami, FL  -  Key Largo, FL

Registration:
Nov 2, 2009
Addresses:
419 NE 19 St, Miami, FL 33132
27 S Exuma Rd, Key Largo, FL 33037
3240 S Dixie Hwy, Miami, FL 33133
State ID:
P09000090432
Business type:
Domestic for Profit Corporation
Chairman, President, Treasurer, Secretarys:
Joseph Gavagni (Vice President, Secretary, Treasurer),Diana S. Glaccum-Gavagni (Chairman, President, Secretary),Diana S. Gavagni-Glaccum Chairman, President, Treasurer, Secretary, inactive

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