Provider Demographics
NPI:1801023486
Name:ADVANCED RHEUMATOLOGY OF CENTRAL FLORIDA, P.L.
Entity Type:Organization
Organization Name:ADVANCED RHEUMATOLOGY OF CENTRAL FLORIDA, P.L.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RHEUMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:GRUNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-953-3712
Mailing Address - Street 1:100 S BELCHER RD
Mailing Address - Street 2:#6087
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758-8902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S BELCHER RD
Practice Address - Street 2:#6087
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33758-8902
Practice Address - Country:US
Practice Address - Phone:727-953-3712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9755207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty