Provider Demographics
NPI:1649371097
Name:GARRO, JOHN (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:GARRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18350 MURDOCK CIR
Mailing Address - Street 2:#102
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1024
Mailing Address - Country:US
Mailing Address - Phone:941-206-7251
Mailing Address - Fax:
Practice Address - Street 1:18350 MURDOCK CIR
Practice Address - Street 2:#102
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1024
Practice Address - Country:US
Practice Address - Phone:941-206-7251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8555207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06370OtherBLUE CROSS BLUE SHIELD
FL272126100Medicaid
FLP00111968OtherRAILROAD MEDICARE
FL06370OtherBLUE CROSS BLUE SHIELD