Individual
KELLY GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
Mailing address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
32320
SC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
D61362
MD
207LP3000X
Pediatric Anesthesiology Physician
Primary
ME154097
FL
207LP3000X
Pediatric Anesthesiology Physician
MT207880
PA
Other
Enumeration date
05/01/2006
Last updated
03/09/2022
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