Provider Demographics
NPI:1619248051
Name:EDUARDO J GARRIDO DC PA
Entity Type:Organization
Organization Name:EDUARDO J GARRIDO DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:GARRIDO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-884-3334
Mailing Address - Street 1:755 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4613
Mailing Address - Country:US
Mailing Address - Phone:305-884-3334
Mailing Address - Fax:305-885-3334
Practice Address - Street 1:755 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4613
Practice Address - Country:US
Practice Address - Phone:305-884-3334
Practice Address - Fax:305-885-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7995111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL53948OtherBLUE CROSS, BLUE SHIELD
FL53948OtherBLUE CROSS, BLUE SHIELD