Healthcare Provider Details

I. General information

NPI: 1427582816
Provider Name (Legal Business Name): DIANA GIRALDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 WILEY ST
HOLLYWOOD FL
33020-6523
US

IV. Provider business mailing address

1528 WILEY ST
HOLLYWOOD FL
33020-6523
US

V. Phone/Fax

Practice location:
  • Phone: 954-297-4545
  • Fax:
Mailing address:
  • Phone: 954-297-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number13901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: