Grimes, Jeremy R

Grimes, Jeremy R is an sole proprietor health care provider with primary practice located at 800 Dunlawton Ave Suite 103, Port Orange FL 32127-4248. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Grimes, Jeremy R can be contacted via phone (386) 679-3270.

Contact Information

Primary practice address
800 Dunlawton Ave Suite 103 Port Orange FL 32127-4248
Phone: (386) 679-3270
Fax: (386) 256-2518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X ME106968 Florida

Profile Details

NPI number 1841482346
LBN Legal business name Grimes, Jeremy R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2007
Last updated May 29th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841482346 NPPES
Florida Other 149KY BCBS
Florida MEDICAID 003790100 BCBS

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