Grzebieluch, Jerzy
Grzebieluch, Jerzy is an sole proprietor health care provider with primary practice located at 4 2Nd St Se , Fort Walton Beach FL 32548-5502. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Grzebieluch, Jerzy can be contacted via phone (850) 864-2008.Contact Information
Primary practice address
4 2Nd St Se
Fort Walton Beach FL 32548-5502
Phone: (850) 864-2008
Fax: (850) 864-5008
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME82784 | Florida |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | ME82784 | Florida |
Profile Details
| NPI number | 1740397025 |
|---|---|
| LBN Legal business name | Grzebieluch, Jerzy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740397025 | NPPES |
| Florida | Other | 53114 | SPECIALITY LICENSE |
| Florida | Other | 13115 | SPECIALITY LICENSE |
| Florida | Other | ME 82784 | SPECIALITY LICENSE |
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