Individual
DR. STEWART A GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
203 KINGSWAY RD, SUITE A, BRANDON, FL 33510-4679
(813) 655-5106
(813) 655-4460
Mailing address
16765 FISHHAWK BLVD, 314, LITHIA, FL 33547-3860
(813) 655-5106
(813) 655-4460
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME72163
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078366
AETNA
FL
01
—
10392101
CITRUS
FL
01
—
132800
AETNA
FL
01
—
209902
AMERIGROUP
FL
01
—
221083
WELLCARE
FL
01
—
2321757005
CIGNA
FL
05
—
252632800
—
FL
05
—
268531100
—
FL
01
—
41515
BCBS
FL
01
—
7557019
AETNA
DC
Enumeration date
07/16/2006
Last updated
11/22/2011
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