Individual
PENELOPE GRULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4850 SW 63RD TER APT 322, DAVIE, FL 33314-4446
(407) 575-5112
Mailing address
4850 SW 63RD TER APT 322, DAVIE, FL 33314-4446
(407) 575-5112
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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