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General NPI Number Information
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NPI Number | 1497016406
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Entity Type | Individual
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Provider Name | JENNIFER GRAYBILL DO
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Gender | Female
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1111 7TH AVE N STE 107
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City | ST PETERSBURG
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State | FL
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Zip | 33705-1348
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Country | US
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Telephone | 727-894-1661
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Fax | 727-894-1430
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Provider Business Mailing Address
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Address Line | 1111 7TH AVE N STE 107
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City | ST PETERSBURG
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State | FL
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Zip | 33705-1348
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Country | US
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Telephone | 727-894-1661
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Fax | 727-894-1430
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS13602
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 266937
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS13602
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License Number State | FL
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