Provider Demographics
NPI:1477738573
Name:GIRALDEZ, LAUREANO A (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREANO
Middle Name:A
Last Name:GIRALDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LAUREANO
Other - Middle Name:
Other - Last Name:GIRALDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 314
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-426-2554
Mailing Address - Fax:787-792-6299
Practice Address - Street 1:B5 CALLE TABONUCO
Practice Address - Street 2:STE 211
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-3013
Practice Address - Country:US
Practice Address - Phone:787-426-2554
Practice Address - Fax:787-792-6299
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18,377207Y00000X
GA67923207Y00000X
NY270425207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology