Provider Demographics
NPI:1760966634
Name:GARRO, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:GARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850001, DEPT 8340
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0001
Mailing Address - Country:US
Mailing Address - Phone:813-536-7277
Mailing Address - Fax:855-830-1722
Practice Address - Street 1:3465 GALT OCEAN DR STE 101
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7077
Practice Address - Country:US
Practice Address - Phone:954-566-7775
Practice Address - Fax:954-566-9997
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9276651363LF0000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice