MEDICARE: GRACIELA R. GARTON 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	2085R0001X	Radiation Oncology Physician	ME0054297	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LF565	OTHER	FL	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1750388849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACIELA R. GARTON MD

Provider Business Mailing Address
First Line	:	1860 BOY SCOUT DR STE 201
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-2119
Country	:	US
Telephone Number	:	239-215-1180
Fax Number	:	239-215-1179

Provider Business Practice Location Address
First Line	:	15681 NEW HAMPSHIRE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4123
Country	:	US
Telephone Number	:	239-437-1977
Fax Number	:	239-437-1889

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	01/09/2020

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