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General NPI Number Information
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NPI Number | 1114642345
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Entity Type | Individual
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Provider Name | MS. CHRISTINA GRAU
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Gender | Female
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 975 BAPTIST WAY
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City | HOMESTEAD
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State | FL
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Zip | 33033-7600
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Country | US
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Telephone | 786-243-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 5787 SUNSET DR APT 5787
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5344
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Country | US
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Telephone | 305-505-4418
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9116622
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License Number State | FL
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