Individual
DESIREE GRANADOS-FISCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19348 LA SERENA DR, FORT MYERS, FL 33967-0525
(239) 691-4535
Mailing address
19348 LA SERENA DR, FORT MYERS, FL 33967-0525
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME89969
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004215500
—
FL
01
—
14HL9
BCBS
FL
01
—
2130785
CIGNA
FL
01
—
7205609
AETNA
FL
01
—
FQ173Z
MEDICARE
FL
01
—
P01000600
RR MEDICARE
FL
Enumeration date
08/11/2006
Last updated
10/05/2012
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