Individual
MARK L GROBELNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 826-4700
(904) 346-0113
Mailing address
PO BOX 863639, ORLANDO, FL 32886-3639
(904) 827-0507
(904) 346-0113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0040072
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55124
BCBS
FL
01
—
P00247295
RAILROAD MEDICARE
FL
Enumeration date
10/04/2006
Last updated
07/08/2007
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