Provider Demographics
NPI:1104049600
Name:DEL GROSSO, ROBERT VAUGHN (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:VAUGHN
Last Name:DEL GROSSO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5088 MERRIFIELD CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-2634
Mailing Address - Country:US
Mailing Address - Phone:352-600-8091
Mailing Address - Fax:
Practice Address - Street 1:8403 BALM ST
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34607-4419
Practice Address - Country:US
Practice Address - Phone:352-340-5936
Practice Address - Fax:352-340-5937
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor