NPIMap

Organization Active NPI

Edward J. Gross M.D., PL

  • Plastic and Reconstructive Surgery Physician
  • Lake Mary, FL
National Provider Identifier
1609948330
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME0074351 Issued in FL
Legal business name
EDWARD J. GROSS M.D., PL
Practice address
1035 Primera Blvd.
Lake Mary, FL 32746
Phone
(407) 333-3040
Fax
(407) 333-3496
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Edward John Gross, M.DNPI 1912929043
Title
Physician
Phone
(407) 333-3040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X ME0074351 FL Primary

Addresses

Primary practice location

1035 Primera Blvd.
Lake Mary, FL 32746

Mailing address

1035 Primera Blvd.
Lake Mary, FL 32746
Phone (407) 333-3040

National Provider Directory

National Provider Directory

Locations

1035 Primera Blvd
Lake Mary, FL 32746
Phone (407) 333-3040

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609948330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PRIMERA BLVD.",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "32746",
            "telephone_number": "407-333-3040",
            "fax_number": "407-333-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PRIMERA BLVD.",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "32746",
            "telephone_number": "407-333-3040",
            "fax_number": "407-333-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J. GROSS M.D., PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-333-3040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME0074351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.