Healthcare Provider Details

I. General information

NPI: 1124950712
Provider Name (Legal Business Name): MARK DANIEL GIRADO CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2026
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18474 SW 136TH CT
MIAMI FL
33177-6259
US

IV. Provider business mailing address

18474 SW 136TH CT
MIAMI FL
33177-6259
US

V. Phone/Fax

Practice location:
  • Phone: 305-281-0691
  • Fax:
Mailing address:
  • Phone: 305-281-0691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number194657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: