Individual
DR. JAMES M GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PLANTATION ISLAND DR S STE 106A, SAINT AUGUSTINE, FL 32080-3109
(904) 814-8365
(904) 217-3224
Mailing address
PO BOX 3266, ST AUGUSTINE, FL 32085-3266
(904) 819-4602
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME68197
FL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME68197
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174540001
DMERC
FL
01
—
OV803
MEDICARE PTAN
FL
Enumeration date
01/23/2006
Last updated
04/01/2024
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