Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gordon L Grenn

Individual provider Family Medicine Physician · NPI 1871603670

Gordon L Grenn is a Family Practice in Lake Worth, Florida. Qualified in 1970, 56 years ago. Practices as a sole proprietor. Licensed in Florida.

Years since qualifying
56
Licensed in
FL
In the registry since
2006
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Practice location Address checks out

4002 Raulerson Dr
Lake Worth, FL 33463-8927
Phone: (561) 964-4077
Fax: (561) 964-9296
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence OS0003345 (FL)

Record details

NPI number1871603670
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 30, 2006
Last updated in NPPESJune 10, 2011
Mailing address4002 Raulerson Road, Lake Worth, FL 33463-8927

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1970 (56 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Lake Worth