Organization
GROGAN SMITH & MARTINI PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN DALE GROGAN C. R.N.A. (PRESIDENT)
(727) 502-5969
Entity
Organization
Contact information
Practice address
148 13TH ST SW, SUITE #200, LARGO, FL 33770-3127
(727) 450-3030
(727) 450-3031
Mailing address
PO BOX 633, LARGO, FL 33779-0633
(727) 450-3030
(727) 450-3031
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305305900
—
FL
01
—
DA9705
RAILROAD MEDICARE
FL
01
—
G9029
BCBS
FL
Enumeration date
04/05/2006
Last updated
05/29/2024
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