Provider Demographics
NPI:1407734015
Name:DE MIRANDA SILVA, GRAZIELA
Entity type:Individual
Prefix:MRS
First Name:GRAZIELA
Middle Name:
Last Name:DE MIRANDA SILVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11733 TIMBERS WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-5568
Mailing Address - Country:US
Mailing Address - Phone:561-305-5495
Mailing Address - Fax:561-305-5495
Practice Address - Street 1:12004 BURTON ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-8853
Practice Address - Country:US
Practice Address - Phone:352-988-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health