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General NPI Number Information
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NPI Number | 1518926351
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Entity Type | Individual
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Provider Name | GERALD E GRUBBS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 600 N CATTLEMEN RD SUITE 100
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City | SARASOTA
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State | FL
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Zip | 34232-6422
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Country | US
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Telephone | 941-378-3231
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Fax | 941-378-3253
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Provider Business Mailing Address
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Address Line | 6600 UNIVERSITY PKWY STE 102
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34240-9040
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Country | US
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Telephone | 941-378-3231
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Fax | 941-378-3253
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME63973
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD61413006
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME63973
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License Number State | FL
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