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General NPI Number Information
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NPI Number | 1336128792
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Entity Type | Individual
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Provider Name | DAVID ROGER GRECH MD
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Gender | Male
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1679 EAGLE HARBOR PKWY STE B
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City | ORANGE PARK
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State | FL
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Zip | 32003-4816
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Country | US
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Telephone | 904-375-8100
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Fax | 904-375-8101
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Provider Business Mailing Address
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Address Line | 3901 UNIVERSITY BLVD S STE 221
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4392
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Country | US
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Telephone | 904-423-0010
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Fax | 904-423-0012
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35058304
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME99750
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License Number State | FL
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