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General NPI Number Information
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NPI Number | 1093772014
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Entity Type | Individual
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Provider Name | KENNETH LLOYD GRILL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 1690 S. CONGRESS AVE. SUITE 100
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6327
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Country | US
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Telephone | 561-488-7771
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Fax | 561-477-3634
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Provider Business Mailing Address
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Address Line | 22282 VISTA LAGO DR.
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City | BOCA RATON
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State | FL
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Zip | 33428-4764
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Country | US
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Telephone | 561-477-3453
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Fax | 561-477-3634
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0003910
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License Number State | FL
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