Provider Demographics
NPI:1649305962
Name:HARRY B GRABOW MD PA
Entity type:Organization
Organization Name:HARRY B GRABOW MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRABOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-921-7744
Mailing Address - Street 1:3920 BEE RIDGE RD
Mailing Address - Street 2:BUILDING F, SUITE A
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-921-7744
Mailing Address - Fax:941-921-3783
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BUILDING F, SUITE A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-921-7744
Practice Address - Fax:941-921-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0023611207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1356344188OtherPERSONAL NPI
FL050530700Medicaid
FL46069OtherPERSONAL MEDICARE PIN
FL46069OtherPERSONAL MEDICARE PIN
FL1356344188OtherPERSONAL NPI