Individual
SHIRINE MARIANNE GHARDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6500 CRILL AVE, PALATKA, FL 32177-9230
(386) 326-0575
(866) 653-0629
Mailing address
7643 GATE PKWY STE 104, PMB 125, JACKSONVILLE, FL 32256-2892
(904) 472-8009
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME58156
FL
207QA0505X
Adult Medicine Physician
ME58156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064646600
—
FL
Enumeration date
05/18/2006
Last updated
12/28/2012
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