Provider Demographics
NPI:1013183607
Name:GARRO, MARIAANDREA (RPT)
Entity Type:Individual
Prefix:
First Name:MARIAANDREA
Middle Name:
Last Name:GARRO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1727
Mailing Address - Country:US
Mailing Address - Phone:760-729-5433
Mailing Address - Fax:760-729-1764
Practice Address - Street 1:2712 MADISON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1727
Practice Address - Country:US
Practice Address - Phone:760-729-5433
Practice Address - Fax:760-729-1764
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 33766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist