Basic Information
| Provider Information | |||||||||
| NPI: | 1316132699 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAZIANI | ||||||||
| FirstName: | ERIKA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.S., R.D., L.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2147 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339022147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394243120 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 708 DEL PRADO BLVD | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | CAPE CORAL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339905616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394243120 | ||||||||
| FaxNumber: | 2394241421 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2007 | ||||||||
| LastUpdateDate: | 09/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 5699 | OH | N | Dietary & Nutritional Service Providers | Dietitian, Registered | 133V00000X | ND7543 | FL | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.