Provider Demographics
NPI:1629087911
Name:GRUMAN, ALLA (MD)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:GRUMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9239
Mailing Address - Country:US
Mailing Address - Phone:941-918-1900
Mailing Address - Fax:941-918-1902
Practice Address - Street 1:929 S TAMIAMI TRL
Practice Address - Street 2:SUITE 201
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9239
Practice Address - Country:US
Practice Address - Phone:941-918-1900
Practice Address - Fax:941-918-1902
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95655207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology