Provider Demographics
NPI:1033720362
Name:GTS MEDICAL
Entity Type:Organization
Organization Name:GTS MEDICAL
Other - Org Name:FAMILY DOCTORS OF PASADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-366-7343
Mailing Address - Street 1:8050 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4808
Mailing Address - Country:US
Mailing Address - Phone:727-275-2005
Mailing Address - Fax:727-498-8951
Practice Address - Street 1:6800 GULFPORT BLVD S STE 101
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-2193
Practice Address - Country:US
Practice Address - Phone:727-275-2005
Practice Address - Fax:727-498-8951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty