Provider Demographics
NPI:1720053127
Name:PATRICK J GRABLIN MD PA
Entity Type:Organization
Organization Name:PATRICK J GRABLIN MD PA
Other - Org Name:GRABLIN ORTHOPAEDIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRABLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-744-9200
Mailing Address - Street 1:530 5TH ST E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-2002
Mailing Address - Country:US
Mailing Address - Phone:941-744-9200
Mailing Address - Fax:941-744-9201
Practice Address - Street 1:530 5TH ST E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208
Practice Address - Country:US
Practice Address - Phone:941-744-9200
Practice Address - Fax:941-744-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66545207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2145580OtherUHC
200039806Medicare PIN
FL3868960002Medicare NSC
K5522Medicare PIN