Individual
DR. RICHARD WARREN GRODIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 STIRRUP KEY BLVD, MARATHON, FL 33050-2943
(954) 363-1011
(561) 807-7836
Mailing address
1568 VICTORIA ISLE WAY, WESTON, FL 33327-1315
(954) 650-5769
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME26691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281015800
—
FL
01
—
93294
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
02/19/2008
Last updated
01/25/2013
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