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General NPI Number Information
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NPI Number | 1366852782
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Entity Type | Organization
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Legal Business Name | GRILLO-ACOSTA MD PA
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 8420 WEST FLAGLER ST SUITE 218
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-222-5005
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Fax |
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Provider Business Mailing Address
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Address Line | 8420 WEST FLAGLER ST SUITE 218
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City | MIAMI
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State | FL
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Zip | 33144
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Country | US
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Telephone | 305-222-5005
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | RAFAEL SANTIAGO GRILLO
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Credential |
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Telephone | 305-222-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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