Graciany Miranda Grajales, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

15543 Issued in PR

Practice address

2804 W Marc Knighton CT
Suite a
Lecanto, FL 34461-9019

Phone

(352) 746-8000

Fax

(352) 746-8001

NPI assigned

Nov 4, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174514319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 W MARC KNIGHTON CT",
            "address_2": "SUITE A",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619019",
            "telephone_number": "352-746-8000",
            "fax_number": "888-325-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 W MARC KNIGHTON CT",
            "address_2": "SUITE A",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619019",
            "telephone_number": "352-746-8000",
            "fax_number": "352-746-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA GRAJALES",
        "first_name": "GRACIANY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "15543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7310343",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA GOLD HMO",
            "identifier": "778245",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSMCA",
            "identifier": "DM154559",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meadowcrest Healthcare Services LLC
• Meadowcrest Healthcare Services LLC
• Medical Risk Solutions
• Vanessa Lynn Mellott, PHARM. D.
• Koanaki Mercado, RN
• Michelle Lynn Mitchell, APRN
• Donna M Montieth, M.S.
• Amaya Morales, OTR
• Cathy K Morey
• Michelle Denise Morgan, D.O.

• General Practice Physician in Lecanto, FL
• Providers in Lecanto, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.