JONATHAN JOSUE GRIJALVA


Address: 1909 White Feather Loop, Oakland, FL 34787-8127
Phone: 4079658567

JONATHAN JOSUE GRIJALVA (NPI# 1639777386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1639777386
Entity Type Individual
Full Name JONATHAN JOSUE GRIJALVA
Practice Address 1909 White Feather Loop
Oakland
FL 34787-8127
Practice Telephone 4079658567
Mailing Telephone 4079658567
Enumeration Date 2020-10-14
Last Update Date 2020-10-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
APRN11009564 FL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1909 WHITE FEATHER LOOP
City OAKLAND
State FL
Zip Code 34787-8127

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City OAKLAND
Zip Code 34787

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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