Individual
JOSE GRULLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18033 PROMENADE PARK LN APT 404, LUTZ, FL 33548-7982
(787) 422-9496
Mailing address
18033 PROMENADE PARK LN APT 404, LUTZ, FL 33548-7982
(787) 422-9496
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
RN9455977
FL
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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