Organization
DALE P GREYSLAK PA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE PHILLIP GREYSLAK PAC (MANAGING MEMBER)
(407) 451-0192
Entity
Organization
Contact information
Practice address
3491 TITANIC CIR, INDIALANTIC, FL 32903-1871
(407) 451-0192
Mailing address
PO BOX 410185, MELBOURNE, FL 32941-0185
(407) 451-0192
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9104508
FL
Other
Enumeration date
01/19/2014
Last updated
12/13/2023
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