| Doctor Name: | MILDRED LOPEZ GARRIDO |
| NPI Number: | 1134523525 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A-C |
| License Number: | PA9108314 |
| Business Practice Address: | 5900 Nw 183rd St Miami Gardens, FL - 330156025 |
| Business Phone Number: | 3055127500 |
| Business Fax Number: | |
| Mailing Address: | 7953 Venetian St, MIRAMAR |
| State: | FL |
| Postal Code: | 330232447 |
| Phone Number: | 7864546866 |
| Fax Number: | |
| NPI Enumeration Date: | 10/15/2014 |
| NPI Last Update Date: | 02/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9108314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |