Provider Demographics
NPI:1023051323
Name:CIRALDO, LORETTA M (MD)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:M
Last Name:CIRALDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18851 NE 29TH AVE
Mailing Address - Street 2:SUITE 768
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2808
Mailing Address - Country:US
Mailing Address - Phone:305-749-3135
Mailing Address - Fax:305-749-3136
Practice Address - Street 1:18851 NE 29TH AVE
Practice Address - Street 2:SUITE 768
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2808
Practice Address - Country:US
Practice Address - Phone:305-749-3135
Practice Address - Fax:305-749-3136
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42094207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79781YMedicare PIN