Provider Demographics
NPI:1467063628
Name:GUILLEN GARRIDO, CARLOS EDUARDO SR
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:EDUARDO
Last Name:GUILLEN GARRIDO
Suffix:SR
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 1:10221 ARIZONA CIR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1227
Mailing Address - Country:US
Mailing Address - Phone:240-328-8886
Mailing Address - Fax:
Practice Address - Street 1:10221 ARIZONA CIR
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1227
Practice Address - Country:US
Practice Address - Phone:240-328-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist