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NPI Code Detail

MEDICARE: DR. JOHN DANIEL GRIGAS MD

MEDICARE: DR. JOHN DANIEL GRIGAS MD
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
1207RP1001XPulmonary Disease PhysicianME0034374FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
156099OTHERFLBCBS OF FLORIDA
24213732OTHERFLAETNA

General Provider Information

NPI Number : 1457339772
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN DANIEL GRIGAS MD
Provider Business Mailing Address
First Line : 800 PRUDENTIAL DR
Second Line : 4TH FLOOR MAIN NORTH
City : JACKSONVILLE
State : FL
Zip : 32207-8202
Country : US
Telephone Number : 904-202-2963
Fax Number : 904-202-4225
Provider Business Practice Location Address
First Line : 800 PRUDENTIAL DR
Second Line : 4TH FLOOR MAIN NORTH
City : JACKSONVILLE
State : FL
Zip : 32207-8202
Country : US
Telephone Number : 904-202-2963
Fax Number : 904-202-4225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 07/08/2007

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