Healthcare Provider Details

I. General information

NPI: 1922057413
Provider Name (Legal Business Name): AITALA GIRON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST 116A11
MIAMI FL
33125-1624
US

IV. Provider business mailing address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-7000
  • Fax: 305-575-3303
Mailing address:
  • Phone: 305-575-7000
  • Fax: 305-575-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number68055
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME0057438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: