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General NPI Number Information
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NPI Number | 1609896737
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Entity Type | Individual
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Provider Name | WILLIAM GROSS D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 6499 38TH AVE N SUITE C-2
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1656
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Country | US
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Telephone | 727-345-0607
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Fax | 727-345-4309
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Provider Business Mailing Address
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Address Line | 6499 38TH AVE N STE C2
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City | ST PETERSBURG
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State | FL
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Zip | 33710-1650
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Country | US
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Telephone | 727-345-0607
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Fax | 727-345-4309
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO-0002411
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License Number State | FL
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