Grossbard, Lee Jay

Grossbard, Lee Jay is an individual health care provider with primary practice located at 13933 17Th St Suite 200, Dade City FL 33525-4604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Grossbard, Lee Jay can be contacted via phone (352) 437-5971.

Contact Information

Primary practice address
13933 17Th St Suite 200 Dade City FL 33525-4604
Phone: (352) 437-5971
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME44251 Florida

Profile Details

NPI number 1730171786
LBN Legal business name Grossbard, Lee Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jul 28th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730171786 NPPES
Florida Other 203003 AMERIGROUP
Florida Other 51224 AMERIGROUP
Florida Other 3705092 AMERIGROUP
Florida Other 020018581 AMERIGROUP
Florida Other 00639 AMERIGROUP
Florida Other 0623994 AMERIGROUP
Florida Other 200072 AMERIGROUP

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