Provider Demographics
NPI:1649326216
Name:GRONING, GUNTHER (MD)
Entity type:Individual
Prefix:DR
First Name:GUNTHER
Middle Name:
Last Name:GRONING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27830 QUIET SKY PLACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4108
Mailing Address - Country:US
Mailing Address - Phone:718-614-1087
Mailing Address - Fax:936-270-8009
Practice Address - Street 1:18004 SW 20TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5209
Practice Address - Country:US
Practice Address - Phone:718-614-1087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134763207Q00000X
TXN6330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME134763OtherFLORIDA MEDICAL LIC
TX218332902Medicaid
TXTXB134498Medicare PIN