Healthcare Provider Details

I. General information

NPI: 1730372145
Provider Name (Legal Business Name): MIROSLAV SERGIO GILARDINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTREAL CHILDREN'S HOSPITAL 2300 TUPPER AVENUE, C11-33
MONTREAL QC
H3H 1P3
CA

IV. Provider business mailing address

809 WILLIAM STREET, SUITE 400
MONTREAL QC
H3C 1N8
CA

V. Phone/Fax

Practice location:
  • Phone: 514-934-1934
  • Fax:
Mailing address:
  • Phone: 514-297-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD430804
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: