MEDICARE: NATALIE MARIE GRILLO

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	174N00000X	Lactation Consultant (Non-RN)	L-318591
2	374J00000X	Doula

General Provider Information

NPI Number	:	1457173981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MARIE GRILLO

Provider Business Mailing Address
First Line	:	1201 SW 128TH TER APT E414
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33027-1972
Country	:	US
Telephone Number	:	954-707-8095
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 N FLAMINGO RD # 1261
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33028-3501
Country	:	US
Telephone Number	:	954-707-8095
Fax Number	:

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

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	06/02/2026

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Directions to “ NATALIE MARIE GRILLO ” Practice Location

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