Gross, Michael David

Gross, Michael David is an individual health care provider with primary practice located at 400 Avenue K Se Suite 11, Winter Haven FL 33880-4146. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Gross, Michael David can be contacted via phone (863) 294-4404.

Contact Information

Primary practice address
400 Avenue K Se Suite 11 Winter Haven FL 33880-4146
Phone: (863) 294-4404
Fax: (863) 294-1059
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 003304 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9101248 Florida

Profile Details

NPI number 1891760427
LBN Legal business name Gross, Michael David
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Mar 30th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891760427 NPPES
Georgia MEDICAID 100002229B
Georgia MEDICAID 2907941-00
Georgia Other 970021690

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