Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME95931 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME95931 | FL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | ME95931 | FL |
NPI | 1316993223 |
---|---|
Provider Name | Grant Garlick |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Temple Terrace, FL 33637-0925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 27/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1336339 | CIGNA (01) | FL |
1415210 | AETNA (01) | FL |
275526200 | (05) | FL |
303140 | AVMED (01) | FL |
54297 | BCBS FLORIDA (01) | FL |
I72097 | (02) | FL |
P00459924 | RAILROAD MEDICARE (01) | FL |