Organization Active NPI

Laura a Gruneiro MD PA

  • Vascular Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1114243466
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME86827 Issued in FL
Legal business name
LAURA A GRUNEIRO MD PA
Practice address
18316 Murdock Cir
Suite 107
Port Charlotte, FL 33948-1008
Phone
(507) 620-7053
NPI assigned
Apr 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Laura Gruneiro, MDNPI 1295704252
Title
Owner
Phone
(570) 620-7053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X ME86827 FL Primary

Addresses

Primary practice location

18316 Murdock Cir
Suite 107
Port Charlotte, FL 33948-1008

Mailing address

18316 Murdock Cir
Suite 107
Port Charlotte, FL 33948-1008
Phone (507) 620-7053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100602000244 FL Part B Supplier - Clinic/Group Practice 1658400577 Receives reassigned benefits from 1 practitioner
Practice locations: Port Charlotte, FL

National Provider Directory

National Provider Directory

Locations

18316 Murdock Cir
Unit 107
Pt Charlotte, FL 33948
Phone (570) 620-7053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1114243466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18316 MURDOCK CIR",
            "address_2": "SUITE 107",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481008",
            "telephone_number": "507-620-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18316 MURDOCK CIR",
            "address_2": "SUITE 107",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481008",
            "telephone_number": "507-620-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA A GRUNEIRO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "GRUNEIRO",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-620-7053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME86827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.