Individual
KELLY GRUCELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
12381 S CLEVELAND AVE STE 405, FORT MYERS, FL 33907-3853
(239) 461-9321
(239) 461-5354
Mailing address
750 N COMMONS DR STE 200, AURORA, IL 60504-7940
(630) 303-5380
(630) 303-5385
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS5299
FL
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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