Provider Demographics
NPI:1316132699
Name:GRAZIANI, ERIKA E (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:E
Last Name:GRAZIANI
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-3120
Mailing Address - Fax:
Practice Address - Street 1:501 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2618
Practice Address - Country:US
Practice Address - Phone:239-424-3120
Practice Address - Fax:239-343-4042
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5699133V00000X
FLND7543133V00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL112375700Medicaid