MEDICARE: ALAN W GRUNING D.O.

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	V3602	TX
2	207Q00000X	Family Medicine Physician	202401664	NC
3	207Q00000X	Family Medicine Physician	TW00530	KS
4	207Q00000X	Family Medicine Physician	OS5181	FL

General Provider Information

NPI Number	:	1932190519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN W GRUNING D.O.

Provider Business Mailing Address
First Line	:	6900 DANIELS PKWY STE 29-173
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7513
Country	:	US
Telephone Number	:	239-939-3303
Fax Number	:

Provider Business Practice Location Address
First Line	:	13450 PARKER COMMONS BLVD STE 103
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1834
Country	:	US
Telephone Number	:	239-939-3303
Fax Number	:

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	03/28/2025

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