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NPI Code Detail

MEDICARE: LEE S GROSS MD

MEDICARE:   LEE S GROSS  MD
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
1207Q00000XFamily Medicine PhysicianME84648FL

General Provider Information

NPI Number : 1467492496
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE S GROSS MD
Provider Business Mailing Address
First Line : 2975 BOBCAT VILLAGE CENTER RD
Second Line : SUITE 100
City : NORTH PORT
State : FL
Zip : 34288-4600
Country : US
Telephone Number : 941-423-9936
Fax Number : 941-426-9794
Provider Business Practice Location Address
First Line : 2975 BOBCAT VILLAGE CENTER RD
Second Line : SUITE 100
City : NORTH PORT
State : FL
Zip : 34288-4600
Country : US
Telephone Number : 941-423-9936
Fax Number : 941-426-9794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 10/10/2011

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Directions to “ LEE S GROSS MD” Practice Location

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