GRANT I DISICK

BOCA RATON, FL
NPI1639236797
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: FL  ME101748)
Enumeration Date2007-01-01
Last Update Date2017-03-16
Business Address
-- GRANT I DISICK MD
9970 CENTRAL PARK BLVD N SUITE 207
BOCA RATON, FL 33428-2231
Phone number: 561-487-5506
Mailing Address
-- GRANT I DISICK MD
2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
FORT MYERS, FL 33907-1412
Phone number: 239-931-7342