Individual
CHRISTINE GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
665 W WARREN AVE, LONGWOOD, FL 32750-4004
(800) 614-4124
Mailing address
665 W WARREN AVE, LONGWOOD, FL 32750-4004
(800) 614-4124
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME0059209
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME0059209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103261400
—
FL
Enumeration date
06/02/2006
Last updated
10/21/2024
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