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Individual

DR. EDMUND G GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14014 N 46TH ST STE C, TAMPA, FL 33613-4238
(813) 971-8811
(813) 355-5054
Mailing address
38135 MARKET SQUARE DR, ZEPHYRHILLS, FL 33542-7505
(525) 670-1883
(813) 355-5101

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0037350
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
068668900
FL
01
30561
BCBS
FL
Enumeration date
07/19/2006
Last updated
03/12/2025
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