Individual
DR. DENISE RICKETTS GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 SE GOLDTREE DR STE 207, PORT ST LUCIE, FL 34952-7583
(772) 249-2494
Mailing address
1713 HWY 441 NORTH, STE C, OKEECHOBEE, FL 34972
(863) 467-2159
(863) 763-0681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 114478
FL
Other
Enumeration date
06/05/2009
Last updated
09/02/2025
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