Provider Demographics
NPI:1316595507
Name:GRULLON, AINEK
Entity Type:Individual
Prefix:MISS
First Name:AINEK
Middle Name:
Last Name:GRULLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 CALLE CANADA
Mailing Address - Street 2:URB PUERTO NUEVO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920
Mailing Address - Country:US
Mailing Address - Phone:207-405-9602
Mailing Address - Fax:
Practice Address - Street 1:PONCE HEALTH SCIENCES UNIVERSITY
Practice Address - Street 2:388 ZONA INDUSTRIAL REPARADA 2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-840-2575
Practice Address - Fax:787-844-1930
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program