Individual provider Active NPI

Karina Grullon-Perez, MD

  • Student in an Organized Health Care Education/Training Program
  • Ft Lauderdale, FL
National Provider Identifier
1376238709
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4725 N Federal Hwy
Ft Lauderdale, FL 33308-4603
Phone
(954) 938-3359
Fax
(954) 492-5790
NPI assigned
Apr 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4725 N Federal Hwy
Ft Lauderdale, FL 33308-4603

Mailing address

4725 N Federal Hwy
Ft Lauderdale, FL 33308-4603
Phone (954) 938-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230622001622 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3072971191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: kgrullon641990@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1376238709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-938-3359",
            "fax_number": "954-492-5790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084603",
            "telephone_number": "954-938-3359",
            "fax_number": "954-492-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRULLON-PEREZ",
        "first_name": "KARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.