Gross, Edward John
Gross, Edward John is an sole proprietor health care provider with primary practice located at 1035 Primera Blvd. , Lake Mary FL 32746-2193. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gross, Edward John can be contacted via phone (407) 333-3040.Contact Information
Primary practice address
1035 Primera Blvd.
Lake Mary FL 32746-2193
Phone: (407) 333-3040
Fax: (407) 333-3496
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | ME0074351 | Florida |
Profile Details
| NPI number | 1912929043 |
|---|---|
| LBN Legal business name | Gross, Edward John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jun 23rd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912929043 | NPPES |
| Florida | Other | 2371491 | AETNA |
| Florida | Other | 593613914 | AETNA |
| Florida | Other | 593613914 | AETNA |
| Florida | Other | 4856086004 | AETNA |
| Florida | Other | 1000573 | AETNA |
| Florida | Other | 46407 | AETNA |
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