Provider Demographics
NPI:1174578009
Name:GIROUD, JORGE M (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:M
Last Name:GIROUD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:840 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:400
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1249
Mailing Address - Country:US
Mailing Address - Phone:727-767-4200
Mailing Address - Fax:727-767-8047
Practice Address - Street 1:880 6TH ST S
Practice Address - Street 2:280
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4827
Practice Address - Country:US
Practice Address - Phone:727-767-4200
Practice Address - Fax:727-821-2461
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL302662080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD57448Medicare UPIN
FL62422WMedicare ID - Type Unspecified