Provider Demographics
NPI:1265633994
Name:BALDARRAGO, GIOVANNA A (MD)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNA
Middle Name:A
Last Name:BALDARRAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 NW 107TH AVE APT 209
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4919
Mailing Address - Country:US
Mailing Address - Phone:786-426-7073
Mailing Address - Fax:
Practice Address - Street 1:1610 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2306
Practice Address - Country:US
Practice Address - Phone:954-922-7400
Practice Address - Fax:954-925-1327
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1206208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice