NPIMap

Organization Active NPI

Edward J. Gross, M.D., P.L.

  • Dermatology Physician
  • Lake Mary, FL
National Provider Identifier
1801219944
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME0074351 Issued in FL
Legal business name
EDWARD J. GROSS, M.D., P.L.
Practice address
1035 Primera Blvd
Lake Mary, FL 32746-2193
Phone
(407) 333-3040
Fax
(407) 333-3496
NPI assigned
Jan 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Authorized official

Name
Dr. Edward J Gross, MD
Title
Owner
Phone
(407) 333-3040

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X ME0074351 FL Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X ME74351 FL

Addresses

Primary practice location

1035 Primera Blvd
Lake Mary, FL 32746-2193

Mailing address

1035 Primera Blvd
Lake Mary, FL 32746-2193
Phone (407) 333-3040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1390608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1801219944",
    "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": "327462193",
            "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": "327462193",
            "telephone_number": "407-333-3040",
            "fax_number": "407-333-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J. GROSS, M.D., P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-25",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-333-3040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0074351",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "ME74351",
            "primary": false
        }
    ],
    "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 5, 2014; 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.