Individual
MRS. RENAE LEA DEGRELLA
Active
Individual
MRS. RENAE LEA DEGRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001887
CT
363A00000X
Physician Assistant
PA9108819
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9108819
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015437600
—
FL
Enumeration date
03/01/2007
Last updated
04/20/2023
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