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General NPI Number Information
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NPI Number | 1265633994
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Entity Type | Individual
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Provider Name | GIOVANNA A BALDARRAGO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2600 VAN BUREN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33020-4818
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Country | US
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Telephone | 954-927-0108
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Fax | 954-927-0206
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Provider Business Mailing Address
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Address Line | 5440 NW 107TH AVE APT 209
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City | DORAL
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State | FL
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Zip | 33178-4919
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Country | US
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Telephone | 786-426-7073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1206
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License Number State | FL
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