Provider Demographics
NPI:1063427748
Name:GARRIGA, ALEX I (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:I
Last Name:GARRIGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6721 CRESCENT LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-4647
Mailing Address - Country:US
Mailing Address - Phone:863-644-4547
Mailing Address - Fax:863-701-9453
Practice Address - Street 1:6721 CRESCENT LAKE DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-4647
Practice Address - Country:US
Practice Address - Phone:863-644-4547
Practice Address - Fax:863-701-9453
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine