Provider Demographics
NPI:1396821765
Name:GUO, TONG
Entity Type:Individual
Prefix:DR
First Name:TONG
Middle Name:
Last Name:GUO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15813
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34604-0124
Mailing Address - Country:US
Mailing Address - Phone:352-683-1928
Mailing Address - Fax:352-683-5725
Practice Address - Street 1:120 MEDICAL BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0221
Practice Address - Country:US
Practice Address - Phone:352-683-1928
Practice Address - Fax:352-683-5725
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist