Prince, Grant

Prince, Grant is an individual health care provider with primary practice located at 1900 Don Wickham Dr Mp Sl Admin, Clermont FL 34711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Prince, Grant can be contacted via phone (352) 536-8840.

Contact Information

Primary practice address
1900 Don Wickham Dr Mp Sl Admin Clermont FL 34711
Phone: (352) 536-8840
Fax: (352) 536-8841
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME126614 Florida

Profile Details

NPI number 1962744367
LBN Legal business name Prince, Grant
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2013
Last updated Nov 16th, 2016 - about 10 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 1962744367 NPPES
Florida Other ME126614 MEDICAL LICENSE
Florida MEDICAID 017422900 MEDICAL LICENSE

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