Provider Demographics
NPI:1588194120
Name:ANGELA M GIRON MD PA
Entity Type:Organization
Organization Name:ANGELA M GIRON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-542-7592
Mailing Address - Street 1:3661 S MIAMI AVE STE 1002
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4214
Mailing Address - Country:US
Mailing Address - Phone:786-502-2688
Mailing Address - Fax:786-502-2699
Practice Address - Street 1:3661 S MIAMI AVE STE 1002
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4214
Practice Address - Country:US
Practice Address - Phone:786-502-2688
Practice Address - Fax:786-502-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103887207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001669300Medicaid