Individual
MR. PAUL MICHAEL LEE GRENELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
303 NO. CLYDE MORRIS BLVD., HALIFAX MEDICAL CENTER, DAYTONA BEACH, FL 32114-2709
(386) 425-2285
(386) 425-7522
Mailing address
PO BOX 864074, HALIFAX HEALTHCARE SYSTEMS, INC., ORLANDO, FL 32886-4074
(386) 226-4590
(386) 226-3371
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105871
FL
363AS0400X
Surgical Physician Assistant
PA9105871
FL
Other
Enumeration date
02/11/2011
Last updated
01/18/2012
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