Provider Demographics
NPI:1669478038
Name:GIRARD, PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:
Last Name:GIRARD
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 1:621 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-5141
Mailing Address - Country:US
Mailing Address - Phone:772-343-8000
Mailing Address - Fax:772-343-7999
Practice Address - Street 1:621 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5141
Practice Address - Country:US
Practice Address - Phone:772-343-8000
Practice Address - Fax:772-343-7999
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71404207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1922812OtherUNITED HEALTH CARE
FL250836200Medicaid
FL5172688OtherAETNA
FL3830923OtherCIGNA
FL1922812OtherUNITED HEALTH CARE
FLG32524Medicare UPIN