MEDICARE: DR. WARREN K GROSS OD

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	152W00000X	Optometrist	OPC1800	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	173129	OTHER	FL	CHILDREN'S MEDICAL SVC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942210455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN K GROSS OD

Provider Business Mailing Address
First Line	:	552 ARTHUR GODFREY RD
Second Line	:	STE A
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140
Country	:	US
Telephone Number	:	305-534-3634
Fax Number	:	305-534-9214

Provider Business Practice Location Address
First Line	:	552 ARTHUR GODFREY RD
Second Line	:	STE A
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3510
Country	:	US
Telephone Number	:	305-534-3634
Fax Number	:	305-534-9214

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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