Healthcare Provider Details

I. General information

NPI: 1386277424
Provider Name (Legal Business Name): ANA GARRIDO DE LA ROSA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 W MAIN ST BUILDING 2, SUITE 1
HAINES CITY FL
33844-8118
US

IV. Provider business mailing address

740 W MAIN ST BUILDING 2, SUITE 1
HAINES CITY FL
33844-4118
US

V. Phone/Fax

Practice location:
  • Phone: 863-256-2829
  • Fax: 863-256-2827
Mailing address:
  • Phone: 863-256-2829
  • Fax: 863-256-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN27042
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDRPM2122
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: