Provider Demographics
NPI:1043338981
Name:GUIDO, MICHAEL A (PT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:GUIDO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11716 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3002
Mailing Address - Country:US
Mailing Address - Phone:216-712-7816
Mailing Address - Fax:216-712-7820
Practice Address - Street 1:11716 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3002
Practice Address - Country:US
Practice Address - Phone:216-712-7816
Practice Address - Fax:216-712-7820
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT004631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist