Provider Demographics
NPI:1346596632
Name:ERNESTO GRENIER M.D. P.A.
Entity Type:Organization
Organization Name:ERNESTO GRENIER M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GRENIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-200-3025
Mailing Address - Street 1:330 SW 27 AVENUE SUITE 604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135
Mailing Address - Country:US
Mailing Address - Phone:786-200-3025
Mailing Address - Fax:
Practice Address - Street 1:330 SW 27 AVENUE SUITE #604
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135
Practice Address - Country:US
Practice Address - Phone:786-200-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1079322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty