Provider Demographics
NPI:1417910282
Name:GIRALA, RICARDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:A
Last Name:GIRALA
Suffix:
Gender:M
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:PO BOX 348447
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33234-8447
Mailing Address - Country:US
Mailing Address - Phone:305-860-1030
Mailing Address - Fax:305-856-0029
Practice Address - Street 1:3661 S MIAMI AVE STE 510
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4200
Practice Address - Country:US
Practice Address - Phone:305-860-1030
Practice Address - Fax:305-856-0029
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 73731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME73731OtherLICENSE
FLG48126Medicare UPIN
FL41873BMedicare ID - Type Unspecified