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Individual

GRACIELA O DEBOCCARDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2852 TAMIAMI TRL STE 1, PORT CHARLOTTE, FL 33952-5100
(941) 505-8720
(941) 505-8747
Mailing address
2852 TAMIAMI TRL STE 1, PORT CHARLOTTE, FL 33952-5100
(941) 505-8720
(941) 505-8747

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
134410
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01126618
NY
05
0591181
NJ
Enumeration date
07/14/2006
Last updated
01/24/2025
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