Individual
DR. EDWARD JOHN GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1035 PRIMERA BLVD., LAKE MARY, FL 32746-2193
(407) 333-3040
(407) 333-3496
Mailing address
1035 PRIMERA BLVD., LAKE MARY, FL 32746-2193
(407) 333-3040
(407) 333-3496
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0074351
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000573
UNITED HEALTHCARE
FL
01
—
2371491
AETNA
FL
01
—
46407
BLUE CROSS/BLUE SHIELD
FL
01
—
4856086004
CIGNA
FL
01
—
593613914
HUMANA
FL
Enumeration date
07/25/2006
Last updated
06/23/2014
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