Individual
DR. GRANT RICHARD GAMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 106002, ATLANTA, GA 30348-6002
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
OS0006312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371050500
—
FL
01
—
80629
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/29/2006
Last updated
05/16/2011
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