Individual
RICHARD E. GROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14205 PINE VALLEY RD, ORLANDO, FL 32826-5276
(814) 771-9682
Mailing address
14205 PINE VALLEY RD, ORLANDO, FL 32826-5276
(814) 771-9682
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD070480L
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD070480L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017919660004
—
PA
Enumeration date
06/14/2005
Last updated
03/16/2015
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