Individual
MR. DAVID EDWARD GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, NP-C
Contact information
Practice address
12470 TELECOM DR, TEMPLE TERRACE, FL 33637-0904
(813) 871-8079
Mailing address
12470 TELECOM DR, TEMPLE TERRACE, FL 33637-0904
(813) 871-8079
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
3007436
KY
363LA2200X
Adult Health Nurse Practitioner
Primary
9469490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811251234
—
FL
Enumeration date
06/29/2012
Last updated
12/01/2017
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