MEDICARE: DR. ERICK ANTONIO GRANA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	ME66670	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952345423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERICK ANTONIO GRANA MD

Provider Business Mailing Address
First Line	:	2333 W HILLSBOROUGH AVE
Second Line	:	SUITE 100
City	:	TAMPA
State	:	FL
Zip	:	33603-1052
Country	:	US
Telephone Number	:	813-872-4492
Fax Number	:	813-870-1502

Provider Business Practice Location Address
First Line	:	2333 W HILLSBOROUGH AVE
Second Line	:	SUITE 100
City	:	TAMPA
State	:	FL
Zip	:	33603-1052
Country	:	US
Telephone Number	:	813-872-4492
Fax Number	:	813-870-1502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	04/05/2016

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