ERICK A GRANA MD PA
Psychiatric at Himes Ave, Tampa, FL

License number
Florida ME0066670
Category
Psychiatric
Type
Interventional Pain Medicine
Owner
Name: DR. ERICK A GRANA M.D.
Title: OWNER
Phone: (813) 935-1284
Address
Address
8011 N Himes Ave STE 2, Tampa, FL 33614
National Provider ID: 1043556186
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ERICK A. GRANA, MD., PA

8011 N Himes Ave STE 2, Tampa, FL 33614

Doing business as:
Erick A. Grana, M.D., PA
Inactive reason:
CONVERSION
Registration:
Dec 28, 2012
Inactive since:
Dec 28, 2012
State ID:
P12000104105
Business type:
Florida Profit Corporation
Director, President:
Erick A Grana (Director, President), 8011 N Himes Ave STE 2, Tampa, FL 33614 (Physical)
Agent:
Jose Ramos,2344 Crestover Ln BLDG 7, Wesley Chapel, FL 33544 (Physical)
EIN:
59-3349030

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