Provider Demographics
NPI:1235525924
Name:GARRIDO SANABRIA, EMILIO RAFAEL (MD, PHD)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:RAFAEL
Last Name:GARRIDO SANABRIA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:EMILIO
Other - Middle Name:R
Other - Last Name:GARRIDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9235
Mailing Address - Fax:239-343-4008
Practice Address - Street 1:6101 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3900
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1402672084N0400X
MN655392084N0400X
WI728862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116973900Medicaid