Provider Demographics
NPI:1104819416
Name:GRIMMETT EYE CARE PLLC
Entity type:Organization
Organization Name:GRIMMETT EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER GRIMMETT EYE CARE
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RALPH
Authorized Official - Last Name:GRIMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-691-3937
Mailing Address - Street 1:3385 BURNS RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4328
Mailing Address - Country:US
Mailing Address - Phone:561-691-3937
Mailing Address - Fax:561-691-3992
Practice Address - Street 1:3385 BURNS RD
Practice Address - Street 2:SUITE 209
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4328
Practice Address - Country:US
Practice Address - Phone:561-691-3937
Practice Address - Fax:561-691-3992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5917Medicare ID - Type Unspecified