Provider Demographics
NPI:1215970207
Name:GARRIDO, MAURICIO (MD)
Entity type:Individual
Prefix:
First Name:MAURICIO
Middle Name:
Last Name:GARRIDO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:5 TOLL
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-4200
Mailing Address - Fax:215-881-9587
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:5 TOLL
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-4200
Practice Address - Fax:215-881-9587
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD430905208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109353Medicare PIN