MEDICARE: TRUDI GRIFFO M.D.

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	207VG0400X	Gynecology Physician	ME92171	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME92171	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1982622379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRUDI GRIFFO M.D.

Provider Business Mailing Address
First Line	:	1012 TAPESTRY LN
Second Line	:
City	:	CELEBRATION
State	:	FL
Zip	:	34747-4031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2506 SAND MINE RD
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33897-3402
Country	:	US
Telephone Number	:	863-424-4321
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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Directions to “ TRUDI GRIFFO M.D.” Practice Location

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