Provider Demographics
NPI:1467516286
Name:GIRALDO, ANDREA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:GIRALDO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 GRANADA AVE
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-5502
Mailing Address - Country:US
Mailing Address - Phone:954-349-3798
Mailing Address - Fax:954-349-8547
Practice Address - Street 1:9 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-1741
Practice Address - Country:US
Practice Address - Phone:954-524-3117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 175921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice