Provider Demographics
NPI:1275537797
Name:GROGG, STEVEN R (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:GROGG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3115
Mailing Address - Country:US
Mailing Address - Phone:941-955-8800
Mailing Address - Fax:941-955-8842
Practice Address - Street 1:1931 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3115
Practice Address - Country:US
Practice Address - Phone:941-955-8800
Practice Address - Fax:941-955-8842
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8062207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics