Provider Demographics
NPI:1780673301
Name:GROVE MED PLUS INC
Entity Type:Organization
Organization Name:GROVE MED PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BLENIUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-446-5917
Mailing Address - Street 1:3640 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4953
Mailing Address - Country:US
Mailing Address - Phone:305-446-5917
Mailing Address - Fax:305-446-0712
Practice Address - Street 1:3640 GRAND AVE
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133-4953
Practice Address - Country:US
Practice Address - Phone:305-446-5917
Practice Address - Fax:305-446-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
72327Medicare ID - Type Unspecified