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Individual

ALBERTO EFRAIM GROSSO ORTIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
1020 HONEY BLOSSOM DR, ORLANDO, FL 32824-4866
(786) 382-9045
Mailing address
1020 HONEY BLOSSOM DR, ORLANDO, FL 32824-4866
(786) 382-9045

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5485232
FL
Enumeration date
04/20/2015
Last updated
04/20/2015
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