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Individual

MS. SANDRA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
318 PARK NORTH CT, WINTER PARK, FL 32789-2553
(407) 928-1404
Mailing address
318 PARK NORTH CT, WINTER PARK, FL 32789-2553
(407) 928-1404

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ARNP 2861772
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G1891A
MEDICARE ID CERTIFICATE
Enumeration date
03/18/2008
Last updated
08/31/2010
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