Provider Demographics
NPI:1043831092
Name:GARRIDO, INES MATILDE (PT)
Entity type:Individual
Prefix:
First Name:INES
Middle Name:MATILDE
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13014 BROWN BARK TRL
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7647
Mailing Address - Country:US
Mailing Address - Phone:352-217-4503
Mailing Address - Fax:
Practice Address - Street 1:2450 PARR DR
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5385
Practice Address - Country:US
Practice Address - Phone:352-269-3508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL115802251C2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary