Organization
PELICAN PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY GRAZIANO (MD/OWNER)
(772) 581-0636
Entity
Organization
Contact information
Practice address
13832 US HIGHWAY 1, SEBASTIAN, FL 32958-3296
(772) 581-0636
Mailing address
13832 US HIGHWAY 1, SEBASTIAN, FL 32958-3296
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME87138
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271342000
—
FL
Enumeration date
02/27/2013
Last updated
02/27/2013
Update your record
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