Healthcare Provider Details

I. General information

NPI: 1306848957
Provider Name (Legal Business Name): JOCELYN CARIN GRENIER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 CORAL HILLS DR SUITE 320
CORAL SPRINGS FL
33065-4172
US

IV. Provider business mailing address

3001 CORAL HILLS DR SUITE 320
CORAL SPRINGS FL
33065-4172
US

V. Phone/Fax

Practice location:
  • Phone: 954-755-0111
  • Fax: 954-755-2209
Mailing address:
  • Phone: 954-755-0111
  • Fax: 954-755-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9102519
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: