MEDICARE: GEORGE DANIEL GRASS M.D., PH.D.

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	2085R0001X	Radiation Oncology Physician	ME140491	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316350234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE DANIEL GRASS M.D., PH.D.

Provider Business Mailing Address
First Line	:	12902 USF MAGNOLIA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-9416
Country	:	US
Telephone Number	:	813-745-1343
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 JIM WALTER BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-5775
Country	:	US
Telephone Number	:	813-745-1600
Fax Number	:

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

Provider Enumeration Date	:	06/09/2014
Last Update Date	:	05/23/2019

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