MEDICARE: DR. KINGA E STYPEREK GROHMANN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	ME85822	FL

General Provider Information

NPI Number	:	1215020839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KINGA E STYPEREK GROHMANN M.D.

Provider Business Mailing Address
First Line	:	2314 S. SEACREST BLVD., SUITE 102
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6788
Country	:	US
Telephone Number	:	561-732-1586
Fax Number	:	561-732-3160

Provider Business Practice Location Address
First Line	:	2314 S. SEACREST BLVD., SUITE 102
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6788
Country	:	US
Telephone Number	:	561-732-1586
Fax Number	:	561-732-3160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/14/2023

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