Provider Demographics
NPI:1629040472
Name:GALLARDO, CARIDAD D (MD)
Entity Type:Individual
Prefix:
First Name:CARIDAD
Middle Name:D
Last Name:GALLARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 SW 117TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-4349
Mailing Address - Country:US
Mailing Address - Phone:305-253-3066
Mailing Address - Fax:
Practice Address - Street 1:3641 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4205
Practice Address - Country:US
Practice Address - Phone:305-854-0302
Practice Address - Fax:305-854-0308
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80093207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03631YOtherBLUE CROSS BLUE SHIELD
03631YMedicare ID - Type Unspecified
FL03631YOtherBLUE CROSS BLUE SHIELD