Healthcare Provider Details

I. General information

NPI: 1124949839
Provider Name (Legal Business Name): LOURDES REMON GARRIDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8651 NW 13TH TER
DORAL FL
33126-1512
US

IV. Provider business mailing address

3555 NW 83RD AVE APT 702
DORAL FL
33122-1166
US

V. Phone/Fax

Practice location:
  • Phone: 305-470-4550
  • Fax:
Mailing address:
  • Phone: 305-470-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number8454
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: