DR. GRACIANY MIRANDA GRAJALES (NPI# 1174514319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174514319 |
| Entity Type | Individual |
| Full Name | DR. GRACIANY MIRANDA GRAJALES |
| Credential | M.D. |
| Practice Address |
2804 W Marc Knighton Ct Suite A Lecanto FL 34461-9019 |
| Practice Telephone | 3527468000 |
| Practice Fax Number | 3527468001 |
| Mailing Telephone | 3527468000 |
| Mailing Fax Number | 8883253690 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2017-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 15543 | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PR | ASSMCA | DM154559 | 01 |
| PR | DEA | BM7396737 | 01 |
| PR | HUMANA GOLD HMO | 778245 | 01 |
| PR | 7310343 | 05 |
| Street Address |
2804 W MARC KNIGHTON CT SUITE A |
| City | LECANTO |
| State | FL |
| Zip Code | 34461-9019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230044 | Lee Elma Howell Jr. | Family Medicine | 2804 W Marc Knighton Ct, Lecanto, FL 34461-6300 | 2005-07-22 |
| 1679963938 | Louis L. Orr Iv | Psychologist | 2804 W Marc Knighton Ct, Suite A, Lecanto, FL 34461-8334 | 2015-01-26 |
| 1225282924 | Board of County Commissioners Citrus County | Community/Behavioral Health | 2804 W Marc Knighton Ct, Suite B, Lecanto, FL 34461-6300 | 2008-11-07 |
| 1225289598 | Michelle Antonia Graham | Dentist | 2804 W Marc Knighton Ct, Lecanto, FL 34461-6300 | 2008-10-06 |
| 1396992558 | Ellen Baxley | Dietitian, Registered | 2804 W Marc Knighton Ct, Lecanto, FL 34461-6300 | 2008-08-19 |
| 1821287954 | Walton L Vanhoose | Dentist | 2804 W Marc Knighton Ct, Lecanto, FL 34461-6300 | 2007-10-15 |
| 1750578019 | Michael Bernard Mueller | Family Medicine | 2804 W Marc Knighton Ct, Lecanto, FL 34461-6300 | 2007-10-01 |
| 1740474568 | Krisha Charlene Fulcher | Psychologist | 2804 W Marc Knighton Ct, Suite A, Lecanto, FL 34461-6300 | 2007-09-05 |
| 1548462393 | Terri Lynette Smith | Family Medicine | 2804 W Marc Knighton Ct, Suite A, Lecanto, FL 34461-6300 | 2007-06-04 |
| 1538211545 | Gainesville Vamc | Clinic/Center | 2804 W Marc Knighton Ct, Suite A, Lecanto, FL 34461-6300 | 2007-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891261160 | Shekinah Barfield | Physician Assistant | Pediatric and Internal Medicine Specialist Inc, 1990 N Prospect Ave, Lecanto, FL 34461 | 2018-10-15 |
| 1699240887 | Medical Risk Solutions | Family Medicine | 2804 W. Marc Knighton Court Key #10, Lecanto, FL 34461 | 2018-10-04 |
| 1851848097 | Pedim Outreach and Specialty Clinic LLC | Family Medicine | 1982 N Prospect Ave, Lecanto, FL 34461 | 2016-09-06 |
| 1265776579 | Wal-mart Stores East Lp | Technician/Technologist | 1936 N. Lecanto Hwy, Lecanto, FL 34461 | 2012-11-27 |
| 1922306109 | Pediatric and Internal Medicine Specialists, Pa | Clinic/Center | 1980 North Prospect Avenue, Lecanto, FL 34461 | 2011-03-11 |
| 1942459078 | Crq Enterprises LLC | Home Health | 4214 W Gulf To Lake Hwy, Lecanto, FL 34461 | 2008-09-12 |
| 1548418064 | Thomas Tybeck | Counselor | 324 S Kensington Ave Ste 328, Lecanto, FL 34461 | 2008-09-09 |
| 1356533566 | Amanda Nicole Coppedge | Optometrist | 240 N. Lecanto Hwy., Lecanto, FL 34461 | 2007-08-11 |
| 1679779185 | Brashears Vital Care Corp | Pharmacy | 471 N Dacie Pt, Lecanto, FL 34461 | 2007-06-22 |
| 1285751099 | Interim Healthcare Private Services, Inc. | Home Health | 581 E. Gulf To Lake Highway, Village West Plaza, Lecanto, FL 34461 | 2007-03-25 |
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| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.