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General NPI Number Information
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NPI Number | 1477591154
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Entity Type | Individual
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Provider Name | MARK S GIRGUIS MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 40946 US HIGHWAY 19 N # 101
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 813-720-7237
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Fax | 888-366-6013
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Provider Business Mailing Address
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Address Line | 40946 US HIGHWAY 19 N # 101
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 813-720-7237
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Fax | 888-366-6013
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME112607
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036166384
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D79826
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A82528
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License Number State | CA
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