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Tabata
Tabata
Grodin
Medical doctor
Wellington, United States
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Florida Health Care Practitioner Data Portal
Full name
TABATA GRODIN
Job Title
Medical Doctor
Location
Wellington, FL, USA
LIC ID
139729
Current License Expiration Date
31/01/2025
Original Date
21/12/2018
Professional Rank Code
ME
Effective Date
21/12/2018
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
PALM BEACH
Practice Location Address Line 1
2800 S Seacrest Blvd
Practice Location Address Line 2
Suite 220
Practice Location Address City
BOYNTON BEACH
Practice Location Address State
FL
Practice Location Address Zipcode
33435
Mode Code
NICA Exempt
Prescribing Indicator
N
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