Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO 0000560 | FL |
NPI | 1104008770 |
---|---|
Provider Name | Dr. David H Gross |
First Address | St. Petersburg, FL 33701 |
Second Address | St. Petersburg, FL 33701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2007 |
Last Update Date | 04/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55387 | (02) | |
T55387 | (02) | FL |