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General NPI Number Information
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NPI Number | 1568638005
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Entity Type | Organization
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Legal Business Name | MARC A GRINBERG MD PA
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 1880 ARLINGTON ST STE 101
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City | SARASOTA
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State | FL
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Zip | 34239-3524
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Country | US
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Telephone | 941-366-7611
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Fax | 941-957-4761
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Provider Business Mailing Address
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Address Line | 1880 ARLINGTON ST STE 101
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City | SARASOTA
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State | FL
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Zip | 34239-3524
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Country | US
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Telephone | 941-366-7611
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Fax | 941-957-4761
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. BILLIE B WINTERS
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Credential |
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Telephone | 941-366-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | ME17033
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License Number State | FL
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