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General NPI Number Information
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NPI Number | 1033720362
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Entity Type | Organization
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Legal Business Name | GTS MEDICAL
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 6800 GULFPORT BLVD S STE 101
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City | SOUTH PASADENA
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State | FL
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Zip | 33707-2193
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Country | US
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Telephone | 727-275-2005
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Fax | 727-498-8951
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Provider Business Mailing Address
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Address Line | 8050 SEMINOLE BLVD
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City | SEMINOLE
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State | FL
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Zip | 33772-4808
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Country | US
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Telephone | 727-275-2005
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Fax | 727-498-8951
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Authorized Official
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Title or Position | MEMBER
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Name | JEFFREY GROVE
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Credential | DO
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Telephone | 727-366-7343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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