Individual
MISS MYRIAM F GRONDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
831 E 12TH AVE, NEW SMYRNA BEACH, FL 32169-3307
(386) 428-5510
Mailing address
831 E 12TH AVE, NEW SMYRNA BEACH, FL 32169-3307
(386) 428-5510
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
678469179
BRAIN AND SPINAL CORD INJURY PROGRAM - PROVIDER #
FL
Enumeration date
03/20/2009
Last updated
03/20/2009
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