Provider Demographics
NPI:1538678347
Name:GRILLO, REBECCA SCHLEMAN (PA-C, RDN, LD/N)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SCHLEMAN
Last Name:GRILLO
Suffix:
Gender:F
Credentials:PA-C, RDN, LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14134 NEPHRON LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-6504
Mailing Address - Country:US
Mailing Address - Phone:727-863-5419
Mailing Address - Fax:727-497-0028
Practice Address - Street 1:2967 LANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-7258
Practice Address - Country:US
Practice Address - Phone:352-684-5323
Practice Address - Fax:352-684-5315
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110702207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty