Individual
DR. MARY CLARKE GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME84259
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME84259
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266131400
—
FL
Enumeration date
12/23/2005
Last updated
12/09/2010
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