Provider Demographics
NPI:1750639902
Name:SAFE HARBOR INSURANCE SERVICES, LLC
Entity Type:Organization
Organization Name:SAFE HARBOR INSURANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:GROTEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-488-5040
Mailing Address - Street 1:3000 GULF TO BAY BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-4321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3000 GULF TO BAY BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-4321
Practice Address - Country:US
Practice Address - Phone:727-394-4060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty