Individual
BRIAN DALE GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
148 13TH ST SW, SUITE #200, LARGO, FL 33770-3127
(727) 450-3030
Mailing address
2253 W BAY ISLE DR SE, ST PETERSBURG, FL 33705-3350
(727) 502-5969
(727) 502-5968
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP911572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303306600
—
FL
01
—
G0161
BCBS
FL
Enumeration date
12/02/2005
Last updated
07/08/2007
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