MEDICARE: MR. CARLOS E. GIROD SR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	02421	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	921441106	OTHER	PR	TRIPLE S PLAN
2	92144GI	OTHER	PR	TRIPLE S PLAN

General Provider Information

NPI Number	:	1417947185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARLOS E. GIROD SR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 13617
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00908-3617
Country	:	US
Telephone Number	:	787-398-0744
Fax Number	:	787-724-1520

Provider Business Practice Location Address
First Line	:	29 WASHINGTON ST
Second Line	:	ASHFORD MEDICAL CENTER 209B
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1509
Country	:	US
Telephone Number	:	787-724-9356
Fax Number	:	787-724-1520

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/30/2018

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Directions to “ MR. CARLOS E. GIROD SR. M.D.” Practice Location

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