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General NPI Number Information
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NPI Number | 1811019045
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Entity Type | Individual
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Provider Name | DAVID FRANK GRIDER D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 29980 OVERSEAS HWY
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City | BIG PINE KEY
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State | FL
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Zip | 33043-3362
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Country | US
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Telephone | 305-872-3321
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Fax | 305-872-9062
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Provider Business Mailing Address
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Address Line | PO BOX 430536
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City | BIG PINE KEY
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State | FL
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Zip | 33043-0536
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Country | US
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Telephone | 305-872-3321
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Fax | 305-872-9062
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-0004048
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License Number State | FL
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