Healthcare Provider Details

I. General information

NPI: 1144488784
Provider Name (Legal Business Name): BARBARA CAROLYN GROGG FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 CORKSCREW RD STE 5
ESTERO FL
33928-3216
US

IV. Provider business mailing address

3010 W GULF DR
SANIBEL FL
33957-5610
US

V. Phone/Fax

Practice location:
  • Phone: 239-949-1212
  • Fax:
Mailing address:
  • Phone: 918-633-2542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11021998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: