Basic Information
| Provider Information | |||||||||
| NPI: | 1689102337 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARIBAY | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4406 CASEY LAKE BLVD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336185307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 18135034232 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1251 LAKELAND HILLS BLVD | ||||||||
| Address2: | |||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338054673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8636872260 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2017 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC5384 | FL | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.