Organization
THE GRANDE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JONES (PART OWNER)
(727) 683-1200
Entity
Organization
Contact information
Practice address
725 DESOTO AVE, BROOKSVILLE, FL 34601-2813
(352) 544-0944
(352) 544-0922
Mailing address
725 DESOTO AVE, BROOKSVILLE, FL 34601-2813
(352) 544-0944
(352) 544-0922
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL11732
FL
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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