Provider Demographics
NPI:1427187343
Name:JOHN P. GIRARD MD PA
Entity Type:Organization
Organization Name:JOHN P. GIRARD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-750-9900
Mailing Address - Street 1:2499 GLADES RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7201
Mailing Address - Country:US
Mailing Address - Phone:561-750-9900
Mailing Address - Fax:561-368-7790
Practice Address - Street 1:2499 GLADES RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7201
Practice Address - Country:US
Practice Address - Phone:561-750-9900
Practice Address - Fax:561-368-7790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02108OtherBLUE CROSS BLUE SHIELD
FL0367591OtherCIGNA
FL02108YOtherPERSONAL MEDICARE #
FL110810BOtherHUMANA
FL60650OtherNHP
FLA86715OtherVISTA HEALTHCARE
FLA86715OtherVISTA OF SOUTH FLORIDA
FL0367591OtherCIGNA
FLDJ098AMedicare UPIN
FLDJ098AMedicare PIN
FLA86715OtherVISTA OF SOUTH FLORIDA
FLDJ098AMedicare PIN