Enrique R Grisoni, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

ME Issued in FL

Practice address

10141 Big Bend Rd
103
Riverview, FL 33578-7419

Phone

(813) 397-1274

Fax

(813) 397-1271

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baycare Medical Group Pediatric Walk-in Care LLC

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1861850117
  NPD (past)
• Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1679724488
  NPD (past)

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1316949944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743409",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743409",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10141 BIG BEND RD",
            "address_2": "103",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335787419",
            "telephone_number": "813-397-1274",
            "fax_number": "813-397-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISONI",
        "first_name": "ENRIQUE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "AZ0884680",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "564642-01",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002583200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Cathryne Griffin, L.M.T.
• Theresa Griffin
• Alicia Grigsby, APRN
• Doris Diane Grimaldi, PHARMD
• Yosanary N Grin Roman, APRN
• Allison Grosse, PHARM.D
• Sheri Leigh Grossglass, MPT
• Peeyush Grover, M.D.
• Growth Mindset Psychology
• Jessica Janina Gruden, DMD

• Pediatric Surgery Physician in Riverview, FL
• Providers in Riverview, FL by specialty
• Pediatric Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.