Provider Demographics
NPI:1942208228
Name:GIRGIS, MAGDI (MD)
Entity Type:Individual
Prefix:MR
First Name:MAGDI
Middle Name:
Last Name:GIRGIS
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 1:306 AVENUE C NE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-4558
Mailing Address - Country:US
Mailing Address - Phone:863-293-1071
Mailing Address - Fax:863-295-9383
Practice Address - Street 1:306 AVENUE C NE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-4558
Practice Address - Country:US
Practice Address - Phone:863-293-1071
Practice Address - Fax:863-295-9383
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00690202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL358012Medicare ID - Type Unspecified
G10657Medicare UPIN