MEDICARE: ARIEL GRIEVE

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	225X00000X	Occupational Therapist	OT16405

General Provider Information

NPI Number	:	1588203186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL GRIEVE

Provider Business Mailing Address
First Line	:	2139 SWEET BRIAR LN
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-2376
Country	:	US
Telephone Number	:	904-874-8775
Fax Number	:

Provider Business Practice Location Address
First Line	:	12350 SAN JOSE BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-2800
Country	:	US
Telephone Number	:	904-621-3131
Fax Number	:

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

Provider Enumeration Date	:	12/30/2019
Last Update Date	:	12/30/2019

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Directions to “ ARIEL GRIEVE ” Practice Location

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