Provider Demographics
NPI:1043343973
Name:GRUBBS, JOHN LEE
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LEE
Last Name:GRUBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9897 MONTCLAIR CIR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1968
Mailing Address - Country:US
Mailing Address - Phone:407-445-8686
Mailing Address - Fax:407-578-8147
Practice Address - Street 1:9897 MONTCLAIR CIR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-1968
Practice Address - Country:US
Practice Address - Phone:407-445-8686
Practice Address - Fax:407-578-8147
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist