Provider Demographics
NPI:1063178259
Name:GIRON-FREAY, ANDRIAN DEJESUS
Entity type:Individual
Prefix:
First Name:ANDRIAN
Middle Name:DEJESUS
Last Name:GIRON-FREAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 ANCHOR AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-2383
Mailing Address - Country:US
Mailing Address - Phone:201-519-8319
Mailing Address - Fax:
Practice Address - Street 1:1802 N BELCHER RD STE 110
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1454
Practice Address - Country:US
Practice Address - Phone:727-201-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist