Grundy, Laurence Shane
Grundy, Laurence Shane is an individual health care provider with primary practice located at 2700 University Square Drive Radiology Associates Of Tampa, Tampa FL 33612-5513. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Grundy, Laurence Shane can be contacted via phone (813) 251-5822.Contact Information
Primary practice address
2700 University Square Drive Radiology Associates Of Tampa
Tampa FL 33612-5513
Phone: (813) 251-5822
Fax: (813) 254-4597
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME71962 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME71962 | Florida |
Profile Details
| NPI number | 1649239054 |
|---|---|
| LBN Legal business name | Grundy, Laurence Shane |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Mar 8th, 2016 - about 8 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 | 1649239054 | NPPES |
| Florida | MEDICAID | 261385900 | |
| Florida | MEDICAID | 118774 |
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