Provider Demographics
NPI:1730134420
Name:GROBES, RODNEY TODD (DPM)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:TODD
Last Name:GROBES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8640 PHILIPS HWY
Mailing Address - Street 2:STE 10
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1207
Mailing Address - Country:US
Mailing Address - Phone:904-469-2432
Mailing Address - Fax:904-779-3348
Practice Address - Street 1:8640 PHILIPS HWY
Practice Address - Street 2:STE 10
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1207
Practice Address - Country:US
Practice Address - Phone:904-469-2432
Practice Address - Fax:904-779-3348
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3368213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFB637UMedicare PIN
DEG01643Medicare PIN
DE1316079569Medicaid