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General NPI Number Information
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NPI Number | 1629865399
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Entity Type | Individual
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Provider Name | JESSICA GRYBKO RCCS, RSC
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 92 W MILLER ST
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City | ORLANDO
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State | FL
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Zip | 32806-2032
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Country | US
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Telephone | 352-875-2694
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Fax |
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Provider Business Mailing Address
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Address Line | 10131 N COUNTRY CLUB WAY
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City | CITRUS SPRINGS
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State | FL
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Zip | 34434-3512
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Country | US
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Telephone |
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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 | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number | 00131588
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 00131588
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License Number State | FL
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