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General NPI Number Information
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NPI Number | 1396951521
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Entity Type | Organization
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Legal Business Name | ALAN W GRUNING DO & ASSOCIATES PA
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 4535 TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-2930
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Country | US
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Telephone | 941-629-9700
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Fax | 941-629-5800
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Provider Business Mailing Address
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Address Line | PO BOX 7151
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City | FORT MYERS
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State | FL
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Zip | 33911-7151
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Country | US
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Telephone | 941-629-9700
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Fax | 941-629-5800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN W GRUNING
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Credential | DO
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Telephone | 941-629-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | OS5181
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License Number State | FL
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