Provider Demographics
NPI:1184617177
Name:CHRISTIE, GRAZIE P (MD)
Entity type:Individual
Prefix:DR
First Name:GRAZIE
Middle Name:P
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160608
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33116-0608
Mailing Address - Country:US
Mailing Address - Phone:305-271-8394
Mailing Address - Fax:786-923-2199
Practice Address - Street 1:9090 SW 87TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2305
Practice Address - Country:US
Practice Address - Phone:305-271-8394
Practice Address - Fax:786-923-2199
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00742742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256718100Medicaid
FL44470Medicare PIN
G94713Medicare UPIN