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Individual

ELIZABETH GRADAILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1975 W 76TH ST, HIALEAH, FL 33014-3269
(305) 512-1220
Mailing address
6989 W 36TH AVE UNIT 204, HIALEAH, FL 33018-2998
(305) 512-1220

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11028167
FL

Other

Enumeration date
09/26/2023
Last updated
09/26/2023
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