Jose Enrique Cosme Grullon

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11418 Issued in PR

Practice address

3201 Budinger Ave
Saint Cloud, FL 34769-7203

Phone

(407) 891-3054

Fax

(888) 477-7678

NPI assigned

Aug 7, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1124507520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12124 CALABOOSE CT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288977",
            "telephone_number": "939-358-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 BUDINGER AVE",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347697203",
            "telephone_number": "407-891-3054",
            "fax_number": "888-477-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSME GRULLON",
        "first_name": "JOSE",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PR",
            "license": "11418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Saint Cloud, FL
• Providers in Saint Cloud, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.