Individual
DR. DAVID GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
506 4TH AVE W, PALMETTO, FL 34221-5203
(941) 933-8108
(941) 933-8109
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME42435
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110169974
RAIL ROAD MEDICARE
FL
05
—
379636100
—
FL
01
—
79789
BCBS
FL
01
—
L8143
MEDICARE
FL
Enumeration date
09/19/2005
Last updated
08/25/2020
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