MEDICARE: MR. RENE GAPASIN GRINO JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	IMH21690	FL

General Provider Information

NPI Number	:	1083378582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RENE GAPASIN GRINO JR.

Provider Business Mailing Address
First Line	:	2718 RIVER OAK DR
Second Line	:
City	:	EGLIN AFB
State	:	FL
Zip	:	32542-1439
Country	:	US
Telephone Number	:	702-722-9451
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 WALTON RD
Second Line	:
City	:	DEFUNIAK SPRINGS
State	:	FL
Zip	:	32433-1538
Country	:	US
Telephone Number	:	850-892-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2021
Last Update Date	:	10/29/2021

Similar Medicare Providers

1568993442 — MICHELLE E TRAVIS M.S., CCC-SLP
Practice Location Address:

1538 CAVE SPRINGS RD
TOMPKINSVILLE, KY
42167-1811

Practice Phone: 270-576-1610
Practice Fax:

1811862063 — NEJAHLEE WILLIAMS
Practice Location Address:

781 SPRINGDALE CIR , 1533 44TH STREET
PALM SPRINGS, FL
33461-1538

Practice Phone: 561-370-8567
Practice Fax:

1629062351 — DR. ROBERT KING PERSONS D.O.
Practice Location Address:

WALTON COUNTY HEALTH DEPARTMENT , 3162 HIGHWAY 83
DEFUNIAK SPRINGS, FL
32433

Practice Phone: 850-892-8015
Practice Fax:

1154391027 — DR. ARJEN L VAN DE VOORDE DDS
Practice Location Address:

362 STATE HIGHWAY 83
DEFUNIAK SPRINGS, FL
32433

Practice Phone: 850-892-8015
Practice Fax:

1790754117 — MRS. ELIZABETH ANNE DIXON ARNP
Practice Location Address:

362 STATE HIGHWAY 83
DEFUNIAK SPRINGS, FL
32433-3800

Practice Phone: 850-892-8015
Practice Fax: 850-892-8024

1992764005 — MRS. SHIRLEY DIANNE GUILLORY ARNP
Practice Location Address:

475 STATE HIGHWAY 83
DEFUNIAK SPRINGS, FL
32433

Practice Phone: 850-892-8015
Practice Fax: 850-892-8457

Directions to “ MR. RENE GAPASIN GRINO JR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.