MEDICARE: CAROL L GRUVER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	44926	GA
2	207RC0000X	Cardiovascular Disease Physician	28211	TN
3	207RC0000X	Cardiovascular Disease Physician	ME166902	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114916939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL L GRUVER MD

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-3660
Fax Number	:	239-343-4133

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD S STE 7
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-2676
Country	:	US
Telephone Number	:	239-424-3660
Fax Number	:	239-343-4133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	11/05/2024

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Directions to “ CAROL L GRUVER MD” Practice Location

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