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General NPI Number Information
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NPI Number | 1770753790
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Entity Type | Organization
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Legal Business Name | FREDERICK A GRASSIN, D.O.
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 5901 MAIN ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2713
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Country | US
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Telephone | 727-849-5445
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Fax | 727-842-6863
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Provider Business Mailing Address
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Address Line | PO BOX 846
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City | NEW PORT RICHEY
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State | FL
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Zip | 34656-0846
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Country | US
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Telephone | 727-849-5445
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Fax | 727-842-6863
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Authorized Official
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Title or Position | OWNER
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Name | DR. FREDERICK A GRASSIN
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Credential | D.O.
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Telephone | 727-849-5445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS1108
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License Number State | FL
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