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Individual

ERIC W REYES GRAJALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2780 CLEVELAND AVE, SUITE 809, FORT MYERS, FL 33901-5817
(239) 343-9680
(239) 343-9685
Mailing address
P.O. BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9680
(239) 343-9685

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
261370
MA
207R00000X
Internal Medicine Physician
Primary
ME126359
FL
207RI0200X
Infectious Disease Physician
261370
MA
207RI0200X
Infectious Disease Physician
ME126359
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016863400
FL
Enumeration date
05/13/2009
Last updated
09/14/2021
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