| Grandin Family Practice Llc | |
|
1326 Sr 100 Grandin FL 32138-0129 | |
| (386) 659-2104 | |
| (386) 659-2196 |
| Full Name | Grandin Family Practice Llc |
|---|---|
| Speciality | General Practice |
| Location | 1326 Sr 100, Grandin, Florida |
| Authorized Official Name and Position | Anita Lenas (OWNER/OPERATOR) |
| Authorized Official Contact | 3866592104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grandin Family Practice Llc Po Box 380129 Grandin FL 32138-0129 Ph: (386) 659-2104 | Grandin Family Practice Llc 1326 Sr 100 Grandin FL 32138-0129 Ph: (386) 659-2104 |
| NPI Number | 1902098296 |
|---|---|
| Provider Enumeration Date | 08/10/2007 |
| Last Update Date | 08/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902098296 | NPI | - | NPPES |
| 00485 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 0065809 (Florida) | Primary |
Birth & Beyond P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1326 State Road 100, Grandin, FL 32138 Phone: 386-659-2104 |