Provider Demographics
NPI:1346690484
Name:GIRARD, LAUREN A (DO)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:A
Last Name:GIRARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 S ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:32118-7639
Mailing Address - Country:US
Mailing Address - Phone:386-767-9544
Mailing Address - Fax:386-767-9914
Practice Address - Street 1:3512 S ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH SHORES
Practice Address - State:FL
Practice Address - Zip Code:32118-7639
Practice Address - Country:US
Practice Address - Phone:386-767-9544
Practice Address - Fax:386-767-9914
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO 5228207Q00000X
FLOS15563390200000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program