Provider Demographics
NPI:1679893135
Name:GARRIDO, VIVIENNE MARTIN (PT)
Entity type:Individual
Prefix:
First Name:VIVIENNE
Middle Name:MARTIN
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VIVIENNE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3704 FAIRWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-3814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6120 U.S. 27 NORTH
Practice Address - Street 2:CORA HEALTH SERVICES - REHABILITATIONAND THERAPY CLINIC
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1221
Practice Address - Country:US
Practice Address - Phone:863-471-1223
Practice Address - Fax:863-471-2015
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12121208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation