Provider Demographics
NPI:1710542824
Name:GROSSMAN, LEAH E (MD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:E
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER OF TRINITY
Mailing Address - Street 2:9330 STATE RD 54
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655
Mailing Address - Country:US
Mailing Address - Phone:727-834-4868
Mailing Address - Fax:727-816-2868
Practice Address - Street 1:MEDICAL CENTER OF TRINITY
Practice Address - Street 2:9330 STATE RD 54
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-834-4868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program