Provider Demographics
NPI:1316595507
Name:GRULLON, AINEK
Entity type:Individual
Prefix:DR
First Name:AINEK
Middle Name:
Last Name:GRULLON
Suffix:
Gender:
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CENTRO MEDICO EPISCOPAL SAN LUCAS
Mailing Address - Street 2:917 AVENIDA TITO CASTRO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733
Mailing Address - Country:US
Mailing Address - Phone:787-844-2080
Mailing Address - Fax:
Practice Address - Street 1:PONCE HEALTH SCIENCES UNIVERSITY
Practice Address - Street 2:388 ZONA INDUSTRIAL REPARADA 2
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-840-2575
Practice Address - Fax:787-844-1930
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR023801208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice