Provider Demographics
NPI:1669852984
Name:GRUBE, JOSHUA DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DALE
Last Name:GRUBE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-226-4590
Mailing Address - Fax:386-226-3371
Practice Address - Street 1:1165 DUNLAWTON AVE STE 105
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127
Practice Address - Country:US
Practice Address - Phone:386-425-4787
Practice Address - Fax:386-425-4788
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2018-08-02
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Provider Licenses
StateLicense IDTaxonomies
FLME129958208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist