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Organization
KEITH A GRAY MD PA
Active
Organization
KEITH A GRAY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WISTERIA Y WYCHE (OFFICE MANAGER)
(407) 839-5063
Entity
Organization
Contact information
Practice address
100 W GORE ST, SUITE 303, ORLANDO, FL 32806-1044
(407) 423-9920
(407) 423-0545
Mailing address
PO BOX 568987, ORLANDO, FL 32856-8987
(407) 423-9920
(407) 423-0545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME41485
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255117900
—
FL
01
—
47582
BC/BS
FL
Enumeration date
08/12/2006
Last updated
04/20/2011
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