Provider Demographics
NPI:1124744537
Name:MCGRAW, GLORIA
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 74TH WAY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6734
Mailing Address - Country:US
Mailing Address - Phone:561-660-0225
Mailing Address - Fax:
Practice Address - Street 1:7408 LAKE WORTH RD STE 900
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2502
Practice Address - Country:US
Practice Address - Phone:561-433-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant