| Doctor Name: | DR. GRACIANY MIRANDA GRAJALES |
| NPI Number: | 1174514319 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 15543 |
| Business Practice Address: | 2804 W Marc Knighton Ct Suite A Lecanto, FL - 344616300 |
| Business Phone Number: | 3527468000 |
| Business Fax Number: | 3527468001 |
| Mailing Address: | 1122 Harmony Ln, CLERMONT |
| State: | FL |
| Postal Code: | 347119019 |
| Phone Number: | 7874324299 |
| Fax Number: | 8883253690 |
| NPI Enumeration Date: | 11/04/2005 |
| NPI Last Update Date: | 06/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15543 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |