Provider Demographics
NPI:1366037418
Name:GIRON, ANDREA VANESSA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:VANESSA
Last Name:GIRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 NW 53RD ST APT 471
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4767
Mailing Address - Country:US
Mailing Address - Phone:786-521-0181
Mailing Address - Fax:
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 1R10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4511
Practice Address - Country:US
Practice Address - Phone:305-909-9104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health