Lissette Grillo

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN9352671 Issued in FL

Practice address

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Phone

(386) 274-0500

NPI assigned

Oct 19, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1700668126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CHELTENHAM AVE",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327389008",
            "telephone_number": "786-481-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "386-274-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "LISSETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "FL",
            "license": "RN9352671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Michael Lee Grenelle, P.A.
• Cameron Gresham
• Greystone Home Healthcare LLC
• Lorie Grgurich
• Cornelia Alice Griffin, N.P.
• Jeremy Robert Grimes, MD
• Reni A Grimes, M.D.
• Kristine Gromlovits
• Robert Marc Grossmann, O.D.
• Christopher Allen Grove, MD

• Community Health Registered Nurse in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Community Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.