Provider Demographics
NPI:1568357135
Name:GIRALD, EDWIN
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:GIRALD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AMALEK
Other - Middle Name:V
Other - Last Name:GIRALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:CALLE MAGNOLIA APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915
Mailing Address - Country:US
Mailing Address - Phone:787-908-3430
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSIDAD CARLOS ALBIZU, 151 CA. DE LA TANCA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901
Practice Address - Country:US
Practice Address - Phone:787-725-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program