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NPI Code Detail

MEDICARE: DR. ROY GRANDO PHD

MEDICARE:  DR. ROY  GRANDO  PHD
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
1103T00000XPsychologist3945AZ
2103T00000XPsychologistPY 00833MO

General Provider Information

NPI Number : 1932143617
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROY GRANDO PHD
Provider Business Mailing Address
First Line : 2998 E HARRISON ST
Second Line :
City : GILBERT
State : AZ
Zip : 85295-9075
Country : US
Telephone Number : 480-275-4063
Fax Number :
Provider Business Practice Location Address
First Line : 3250 N PINAL PKWY
Second Line : MEDICAL UNIT
City : FLORENCE
State : AZ
Zip : 85132-9459
Country : US
Telephone Number : 520-868-8443
Fax Number : 520-868-1547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 03/12/2013

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Directions to “ DR. ROY GRANDO PHD” Practice Location

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