Healthcare Provider Details

I. General information

NPI: 1235525924
Provider Name (Legal Business Name): EMILIO RAFAEL GARRIDO SANABRIA M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EMILIO R GARRIDO M.D., PH.D

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 PINE RIDGE RD
NAPLES FL
34119-3900
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-4221
  • Fax:
Mailing address:
  • Phone: 239-343-9235
  • Fax: 239-343-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME140267
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number65539
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberME140267
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number72886
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: