Provider Demographics
NPI:1912743824
Name:GRATEFUL HEALTH LLC
Entity type:Organization
Organization Name:GRATEFUL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:AOUNI
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:321-746-4208
Mailing Address - Street 1:2425 S VOLUSIA AVE STE B3
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7625
Mailing Address - Country:US
Mailing Address - Phone:386-218-3145
Mailing Address - Fax:386-218-3115
Practice Address - Street 1:2425 S VOLUSIA AVE STE B3
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7625
Practice Address - Country:US
Practice Address - Phone:386-218-3145
Practice Address - Fax:386-218-3115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty