Provider Demographics
NPI:1902000300
Name:GARRATON, GILDA (OD)
Entity Type:Individual
Prefix:DR
First Name:GILDA
Middle Name:
Last Name:GARRATON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 NW 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3037
Mailing Address - Country:US
Mailing Address - Phone:954-346-8578
Mailing Address - Fax:
Practice Address - Street 1:8903 GLADES RD
Practice Address - Street 2:BAY 1-4
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4074
Practice Address - Country:US
Practice Address - Phone:561-477-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP 2731152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24851Medicare UPIN
FL20556Medicare ID - Type Unspecified