Individual
AILEEN MARIE GRULLON-COLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
14201 W SUNRISE BLVD, SUITE 107, SUNRISE, FL 33323-3207
(954) 756-2818
(954) 514-1126
Mailing address
14201 W SUNRISE BLVD STE 107, SUNRISE, FL 33323-3207
(954) 536-1806
(954) 514-1126
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
FL
235Z00000X
Speech-Language Pathologist
Primary
SA7777
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130469600
MEDICAID PROFESSIONAL EARLY INTERVENTION SERVICES
FL
05
—
888570200
—
FL
Enumeration date
12/19/2006
Last updated
04/06/2026
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