Provider Demographics
NPI:1740497718
Name:GRILLOARROYO, JOSE A
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:GRILLOARROYO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1600 SUITE 350
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739
Mailing Address - Country:US
Mailing Address - Phone:787-466-4777
Mailing Address - Fax:787-747-4462
Practice Address - Street 1:BO CANABONCITO CARR 172
Practice Address - Street 2:SECT. LOS MELENDEZ
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-466-4777
Practice Address - Fax:787-747-4462
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier