Healthcare Provider Details

I. General information

NPI: 1871219261
Provider Name (Legal Business Name): ELISABETH ONDREY GRUBER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LIZ GRUBER PHD

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 ALOMA AVE STE 245
WINTER PARK FL
32792-2541
US

IV. Provider business mailing address

2431 ALOMA AVE # 245
WINTER PARK FL
32792-2541
US

V. Phone/Fax

Practice location:
  • Phone: 561-600-1914
  • Fax:
Mailing address:
  • Phone: 561-600-1914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number11633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: