Provider Demographics
NPI:1376582064
Name:PESCE-GUTTVEG, ANDREA P (LIC ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:P
Last Name:PESCE-GUTTVEG
Suffix:
Gender:F
Credentials:LIC ACUPUNCTURIST
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:PESCE
Other - Last Name:GUTTVEG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2402 ECUADORIAN WAY
Mailing Address - Street 2:APT 8
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763
Mailing Address - Country:US
Mailing Address - Phone:727-458-6207
Mailing Address - Fax:
Practice Address - Street 1:1230B LADY MARION LANE
Practice Address - Street 2:SUITE B
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698
Practice Address - Country:US
Practice Address - Phone:727-736-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist