Basic Information
| Provider Information | |||||||||
| NPI: | 1851340947 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGUEREDO-CARDENAS | ||||||||
| FirstName: | GRISELLE | ||||||||
| MiddleName: | VIRGINIA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8400 NW 33RD ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | DORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7864088502 | ||||||||
| FaxNumber: | 3059217355 | ||||||||
| Practice Location | |||||||||
| Address1: | 3617 W HILLSBOROUGH AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138752020 | ||||||||
| FaxNumber: | 8557852883 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2006 | ||||||||
| LastUpdateDate: | 10/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 31712 | TN | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME123886 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 31712 | 01 | TN | LICENSE | OTHER |