Provider Demographics
NPI:1437985967
Name:GRIFFIS, ADEA AZIZA
Entity type:Individual
Prefix:
First Name:ADEA
Middle Name:AZIZA
Last Name:GRIFFIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6995 SAWFISH ST
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-6615
Mailing Address - Country:US
Mailing Address - Phone:804-914-2500
Mailing Address - Fax:
Practice Address - Street 1:6845 NAVARRE PKWY
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7420
Practice Address - Country:US
Practice Address - Phone:804-914-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach