Individual
LISSETTE GRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 HOLSONBACK DR, DAYTONA BEACH, FL 32117-5114
(386) 274-0500
Mailing address
690 CHELTENHAM AVE, DELTONA, FL 32738-9008
(786) 481-8383
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN9352671
FL
Other
Enumeration date
10/19/2023
Last updated
10/19/2023
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