Provider Demographics
NPI:1679687537
Name:GREY, HYACINTH ELAINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:HYACINTH
Middle Name:ELAINE
Last Name:GREY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10300 SW 216TH ST
Mailing Address - Street 2:N/A
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1003
Mailing Address - Country:US
Mailing Address - Phone:305-253-5100
Mailing Address - Fax:305-254-4901
Practice Address - Street 1:10300 SW 216TH ST
Practice Address - Street 2:N/A
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1003
Practice Address - Country:US
Practice Address - Phone:305-253-5100
Practice Address - Fax:305-254-4901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2116592363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305892100Medicaid
FLU-PIN Q0558Medicare UPIN
FL305892100Medicaid