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General NPI Number Information
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NPI Number | 1073198479
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Entity Type | Individual
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Provider Name | KIMBERLY GRISANTI APRN
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 1852 HILLVIEW ST STE 301
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City | SARASOTA
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State | FL
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Zip | 34239-3638
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Country | US
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Telephone | 941-262-0400
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Fax | 941-262-0410
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Provider Business Mailing Address
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Address Line | PO BOX 863407
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City | ORLANDO
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State | FL
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Zip | 32886-3407
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Country | US
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Telephone | 941-917-2600
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Fax | 941-917-7884
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11008760
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License Number State | FL
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