Healthcare Provider Details

I. General information

NPI: 1235323486
Provider Name (Legal Business Name): HERNANDO GIRALDO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 W ATLANTIC AVE
DELRAY BEACH FL
33445-3838
US

IV. Provider business mailing address

200 E HALLANDALE BEACH BLVD
HALLANDALE BEACH FL
33009-5525
US

V. Phone/Fax

Practice location:
  • Phone: 561-453-2273
  • Fax:
Mailing address:
  • Phone: 954-362-8677
  • Fax: 954-458-8167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA SAMUELSON
Title or Position: CEO
Credential:
Phone: 561-859-5052