Organization
BACKMDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALTER MATTHEW GROTEKE (OWNER)
(727) 488-5040
Entity
Organization
Contact information
Practice address
3006 GULF TO BAY BLVD, CLEARWATER, FL 33759-4313
(727) 488-5040
Mailing address
3006 GULF TO BAY BLVD, CLEARWATER, FL 33759-4313
(727) 488-5040
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME115987
FL
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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