Grooms, John O

Grooms, John O is an individual health care provider with primary practice located at 950 N Avalon Way , Lecanto FL 34461-6004. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Grooms, John O can be contacted via phone (352) 746-2663.

Contact Information

Primary practice address
950 N Avalon Way Lecanto FL 34461-6004
Phone: (352) 746-2663
Fax: (352) 746-6907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA3291 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA3291 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA3291 Florida

Profile Details

NPI number 1962549097
LBN Legal business name Grooms, John O
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Mar 15th, 2011 - about 15 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 1962549097 NPPES
Florida MEDICAID 292891400

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