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Individual

DR. GRACIANY MIRANDA GRAJALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2804 W MARC KNIGHTON CT, SUITE A, LECANTO, FL 34461-9019
(352) 746-8000
(352) 746-8001
Mailing address
2804 W MARC KNIGHTON CT, SUITE A, LECANTO, FL 34461-9019
(352) 746-8000
(888) 325-3690

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
15543
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7310343
PR
01
778245
HUMANA GOLD HMO
PR
01
DM154559
ASSMCA
PR
Enumeration date
11/04/2005
Last updated
03/07/2023
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