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NPI Code Detail

MEDICARE: JONATHAN GROEMM

MEDICARE: JONATHAN GROEMM
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1538003207
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN GROEMM
Provider Business Mailing Address
First Line : 745 ORIENTA AVE STE 1011
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-5675
Country : US
Telephone Number : 877-823-4283
Fax Number :
Provider Business Practice Location Address
First Line : 4532 US HIGHWAY 19
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-4950
Country : US
Telephone Number : 877-823-4283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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