Individual
GRANT GARLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 558-6145
Mailing address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 972-5055
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME95931
FL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
ME95931
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
ME95931
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336339
CIGNA
FL
01
—
1415210
AETNA
FL
05
—
275526200
—
FL
01
—
303140
AVMED
FL
01
—
54297
BCBS FLORIDA
FL
01
—
P00459924
RAILROAD MEDICARE
FL
Enumeration date
05/25/2006
Last updated
04/01/2025
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