Individual
MR. WALTER MATTHEW GROTEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1102 S BAYSHORE BLVD, SAFETY HARBOR, FL 34695-4258
(727) 488-5040
Mailing address
1102 S BAYSHORE BLVD, SAFETY HARBOR, FL 34695-4258
(727) 488-5040
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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