Provider Demographics
NPI:1861628885
Name:GRAZIANO, PATRICIA (DOM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1995
Mailing Address - Street 2:
Mailing Address - City:ANNA MARIA
Mailing Address - State:FL
Mailing Address - Zip Code:34216-1995
Mailing Address - Country:US
Mailing Address - Phone:941-773-6134
Mailing Address - Fax:
Practice Address - Street 1:2313 GULF DR
Practice Address - Street 2:
Practice Address - City:BRADENTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:34217-2239
Practice Address - Country:US
Practice Address - Phone:941-773-6134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2350171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist