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General NPI Number Information
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NPI Number | 1346975372
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Entity Type | Individual
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Provider Name | VANJA GRBIC MEDICAL TATTOO ARTIS
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 7519 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5109
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Country | US
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Telephone | 407-463-9558
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Fax |
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Provider Business Mailing Address
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Address Line | 5377 WATERVISTA DR
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City | ORLANDO
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State | FL
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Zip | 32821-5548
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Country | US
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Telephone | 407-463-9558
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 48-44-2108197
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License Number State | FL
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