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NPI Code Detail

MEDICARE: YEKATERINA GRIGOL PA

MEDICARE: YEKATERINA GRIGOL PA
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
1363AM0700XMedical Physician AssistantPA9109386FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558734178
Entity Type Code : Individual
Provider Name (Legal Business Name) : YEKATERINA GRIGOL PA
Provider Business Mailing Address
First Line : 6605 HILLWAY CIR STE 101
Second Line :
City : NAPLES
State : FL
Zip : 34112-8754
Country : US
Telephone Number : 786-239-3066
Fax Number :
Provider Business Practice Location Address
First Line : 6605 HILLWAY CIR STE 101
Second Line :
City : NAPLES
State : FL
Zip : 34112-8754
Country : US
Telephone Number : 239-262-6550
Fax Number : 954-933-8539
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2015
Last Update Date : 12/05/2025

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Directions to “ YEKATERINA GRIGOL PA” Practice Location

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