Provider Demographics
NPI:1093820334
Name:MCGROGAN, WILLIAM F (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:MCGROGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 S HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3126
Mailing Address - Country:US
Mailing Address - Phone:813-443-1426
Mailing Address - Fax:813-280-2881
Practice Address - Street 1:1423 S HOWARD AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3126
Practice Address - Country:US
Practice Address - Phone:813-443-1426
Practice Address - Fax:813-280-2881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76646207R00000X
FLME76646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44449OtherBCBS
FL256391600Medicaid
FL256391600Medicaid
FLGN889ZMedicare PIN
FLG80909Medicare UPIN