Organization
EDMUND G GRANT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND GUY GRANT JR. MD (PRESIDENT)
(813) 971-8811
Entity
Organization
Contact information
Practice address
13801 BRUCE B DOWNS BLVD, SUITE 401, TAMPA, FL 33613-3946
(813) 971-8811
(813) 971-6951
Mailing address
13801 BRUCE B DOWNS BLVD, SUITE 401, TAMPA, FL 33613-3946
(813) 971-8811
(813) 971-6951
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0037350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068668900
—
FL
Enumeration date
05/19/2010
Last updated
08/09/2010
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