Provider Demographics
NPI:1366780793
Name:GARRIDO-GOICO, EDUARDO JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:JOSE
Last Name:GARRIDO-GOICO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8401
Mailing Address - Country:US
Mailing Address - Phone:980-498-3900
Mailing Address - Fax:888-489-2811
Practice Address - Street 1:10340 PARK RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8401
Practice Address - Country:US
Practice Address - Phone:980-498-3900
Practice Address - Fax:888-489-2811
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01686208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2015-01686OtherLICENSE