MEDICARE: DR. LORENA M GRULLON-FIGUEROA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	251831	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437316866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORENA M GRULLON-FIGUEROA M.D.

Provider Business Mailing Address
First Line	:	920 RIVERSIDE DR APT 6A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-5464
Country	:	US
Telephone Number	:	212-781-6872
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W COLONIAL DR STE 302
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	615-498-3788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	10/26/2022

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