Individual
DR. DENIS WALTER GRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
790 SE 5TH TER, CRYSTAL RIVER, FL 34429-4852
(352) 795-0011
(352) 795-9481
Mailing address
790 SE 5TH TER, CRYSTAL RIVER, FL 34429-4852
(352) 795-0011
(352) 795-9481
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
OS5716
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1409549
UMW
FL
01
—
200691
AVMED
FL
01
—
80221
BCBS OF FLORIDA
FL
01
—
P00062969
MEDICARE RAILROAD
FL
Enumeration date
10/07/2005
Last updated
09/11/2018
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