Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | ME33571 | FL |
N | 207Q00000X | Family Doctor | ME33571 | FL |
N | 207QA0505X | Family Doctor - Adult Medicine | ME33571 | FL |
N | 207QS0010X | Family Doctor - Sports Medicine | ME33571 | FL |
Y | 208000000X | Pediatrician | ME33571 | FL |
N | 2080A0000X | Adolescent Medicine | ME33571 | FL |
N | 2080P0207X | Pediatric Hematology-Oncologist | ME33571 | FL |
NPI | 1679599559 |
---|---|
Provider Name | Dr. Ann Mcguire Grooms |
First Address | Orlando, FL 32891-8025 |
Second Address | Gainesville, FL 32610-3003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 18/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003067600 | (05) | FL |