Provider Demographics
NPI:1669667556
Name:DOUGAN, GRACE CASTRO (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:CASTRO
Last Name:DOUGAN
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 W. MARTIN LUTHER KING JR. BLVD
Mailing Address - Street 2:3RD FLOOR MEDICAL ARTS BUILDING
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607
Mailing Address - Country:US
Mailing Address - Phone:813-554-8420
Mailing Address - Fax:813-554-8377
Practice Address - Street 1:3001 W. MARTIN LUTHER KING JR. BLVD
Practice Address - Street 2:3RD FLOOR MEDICAL ARTS BUILDING
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-554-8420
Practice Address - Fax:813-554-8377
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1080002080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology