MEDICARE: GROVE MED PLUS INC

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	207Q00000X	Family Medicine Physician	HCC3387	FL

General Provider Information

NPI Number	:	1780673301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROVE MED PLUS INC

Provider Business Mailing Address
First Line	:	3640 GRAND AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-4953
Country	:	US
Telephone Number	:	305-446-5917
Fax Number	:	305-446-0712

Provider Business Practice Location Address
First Line	:	3640 GRAND AVE
Second Line	:
City	:	COCONUT GROVE
State	:	FL
Zip	:	33133-4953
Country	:	US
Telephone Number	:	305-446-5917
Fax Number	:	305-446-0712

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PIERRE R BLENIUR
Credential	:	MD
Telephone Number	:	305-446-5917

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	08/22/2020

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Directions to “GROVE MED PLUS INC ” Practice Location

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