Healthcare Provider Details

I. General information

NPI: 1083057541
Provider Name (Legal Business Name): ALMA REGINA GARRIDO MS,RD,LD/N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 04/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 REBECCA DR NE
WINTER HAVEN FL
33881-2712
US

IV. Provider business mailing address

136 REBECCA DR NE
WINTER HAVEN FL
33881-2712
US

V. Phone/Fax

Practice location:
  • Phone: 863-292-0597
  • Fax:
Mailing address:
  • Phone: 863-292-0597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberND3239
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberND3239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: