# WILLIAM J GRISAITIS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831375435
- **Authorized official:** WILLIAM J GRISAITIS MD (OWNER)
- **Authorized official phone:** (407) 644-9030

## Contact information

- **Practice address:** 331 N MAITLAND AVE, \#A-5, MAITLAND, FL 32751-4762
- **Practice address phone:** (407) 644-9030
- **Practice address fax:** (407) 644-9440
- **Mailing address:** 331 N MAITLAND AVE, \#A-5, MAITLAND, FL 32751-4762
- **Mailing address phone:** (407) 644-9030
- **Mailing address fax:** (407) 644-9440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | ME35814 | FL | Yes |

## Other

- **Enumeration date:** 01/14/2008
- **Last updated:** 08/13/2010