MEDICARE: GENNELL GRANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	MA 67006	FL

General Provider Information

NPI Number	:	1982096905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENNELL GRANT

Provider Business Mailing Address
First Line	:	619 16TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-5407
Country	:	US
Telephone Number	:	727-709-8755
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 16TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-5407
Country	:	US
Telephone Number	:	727-709-8755
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2015
Last Update Date	:	02/27/2015

Similar Medicare Providers

1821574740 — ALANA BENITO RD, LDN
Practice Location Address:

699 16TH AVE S
ST PETERSBURG, FL
33701-5407

Practice Phone: 860-944-0232
Practice Fax:

1902515521 — VIDA EATS, LLC
Practice Location Address:

699 16TH AVE S
ST PETERSBURG, FL
33701-5407

Practice Phone: 860-944-0232
Practice Fax:

1578597415 — OXYGEN SUPPORT SERVICES, INC
Practice Location Address:

3425 11TH AVE N
ST PETERSBURG, FL
33713-5407

Practice Phone: 727-327-7133
Practice Fax: 727-327-6633

1740608587 — DR. ALEXANDER HO PHARMD
Practice Location Address:

7491 4TH ST N
ST PETERSBURG, FL
33702-5407

Practice Phone: 727-528-2123
Practice Fax:

1386036747 — LEIGH ANNE BOWEN PHARMD
Practice Location Address:

7491 4TH ST N
ST PETERSBURG, FL
33702-5407

Practice Phone: 727-528-2123
Practice Fax: 727-528-2132

1588236566 — ABERE S CHURCH
Practice Location Address:

7401 4TH ST N STE 300
ST PETERSBURG, FL
33702-5407

Practice Phone: 253-355-8414
Practice Fax:

Directions to “ GENNELL GRANT ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.