| Edmund G Grant Md Pa | |
|
13801 Bruce B Downs Blvd Suite 401 Tampa FL 33613-3946 | |
| (813) 971-8811 | |
| (813) 971-6951 |
| Full Name | Edmund G Grant Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 13801 Bruce B Downs Blvd, Tampa, Florida |
| Authorized Official Name and Position | Edmund Guy Grant (PRESIDENT) |
| Authorized Official Contact | 8139718811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmund G Grant Md Pa 13801 Bruce B Downs Blvd Suite 401 Tampa FL 33613-3946 Ph: (813) 971-8811 | Edmund G Grant Md Pa 13801 Bruce B Downs Blvd Suite 401 Tampa FL 33613-3946 Ph: (813) 971-8811 |
| NPI Number | 1962721761 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 08/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962721761 | NPI | - | NPPES |
| 068668900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | ME0037350 (Florida) | Primary |
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