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Individual

DR. DARIO AQUILES GRISALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16542 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 908-7868
(813) 908-8091
Mailing address
16542 N DALE MABRY HWY, TAMPA, FL 33618-1325
(813) 908-7868
(813) 908-8091

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
ME79046
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03185
BLUE CROSS BLUE SHIELD
FL
01
P00246786
RAILROAD MEDICARE
FL
Enumeration date
11/21/2005
Last updated
05/06/2011
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