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1417817107 NPI number — JOSE ARIEL GIRALDO FLOREZ MD

NPI Number: 1417817107
Health Care Provider/Practitioner: JOSE ARIEL GIRALDO FLOREZ MD

Information about “1417817107” NPI (JOSE ARIEL GIRALDO FLOREZ MD) exists in 1417817107 in HTML format HTML  |  1417817107 in plain Text format TXT  |  1417817107 in PDF (Portable Document Format) PDF  |  1417817107 in an XML format XML  formats.

NPI Number : 1417817107 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1417817107",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GIRALDO FLOREZ",
    "FirstName": "JOSE",
    "MiddleName": "ARIEL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1405 EARNEST WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ODENTON",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21113-4076",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "667-417-5431",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1120 15TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "AUGUSTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30912-0004",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "706-721-7869",
    "PracticeLocationAddressFaxNumber": "706-721-7763",
    "EnumerationDate": "11/14/2025",
    "LastUpdateDate": "11/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207L00000X",
        "TaxonomyName": "Anesthesiology Physician",
        "LicenseNumber": "110174",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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