Provider Demographics
NPI:1467565994
Name:GIRARD, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:GIRARD
Suffix:
Gender:M
Credentials:MD
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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:33431-7209
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:33431-7209
Practice Address - Country:US
Practice Address - Phone:561-750-9900
Practice Address - Fax:561-368-7790
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2014-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0049001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02108OtherBCBS
FL0367591OtherCIGNA
FL60650OtherNEIGHBORHOOD
FL2494943OtherAETNA
FL104722OtherAVMED
FLA86715OtherVISTA
FL60650OtherNEIGHBORHOOD
FL02108YMedicare PIN
FL02108OtherBCBS