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Jose Enrique Cosme Grullon

Social Worker in Saint Cloud, FL. Individual provider (NPI-1).

NPI number1124507520
StatusActive
Last updated in NPPESAug 7, 2018

Details

NPI
1124507520
Entity type
Individual (NPI-1)
Name
Jose Enrique Cosme Grullon
Sex
Male
Sole proprietor
No
Enumeration date
Aug 7, 2018
Last updated
Aug 7, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
104100000X Social Worker11418PRYes
171M00000X Case Manager/Care Coordinator––

Practice location

3201 Budinger Ave
Saint Cloud, FL 34769-7203

Phone 407-891-3054 · Fax 888-477-7678

Mailing address

12124 Calaboose Ct
Orlando, FL 32828-8977

Phone 939-358-7056

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