MEDICARE: FERNANDO FRIAS GRISHKO

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	207R00000X	Internal Medicine Physician	ME170813	FL

General Provider Information

NPI Number	:	1508506288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO FRIAS GRISHKO

Provider Business Mailing Address
First Line	:	10101 FOREST HILL BLVD
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6103
Country	:	US
Telephone Number	:	561-798-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	10101 FOREST HILL BLVD
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6103
Country	:	US
Telephone Number	:	561-798-8500
Fax Number	:

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

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	12/09/2025

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Directions to “ FERNANDO FRIAS GRISHKO ” Practice Location

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