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:
Health care specialties
Specialty | Code | License # | 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 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1841482346 | NPPES |
Florida | Other | 149KY | BCBS |
Florida | MEDICAID | 003790100 | BCBS |
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