Provider Demographics
NPI:1437551512
Name:GUAN, WEIWEI (DPT)
Entity Type:Individual
Prefix:
First Name:WEIWEI
Middle Name:
Last Name:GUAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7795 SW 79TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-9493
Mailing Address - Country:US
Mailing Address - Phone:813-748-2388
Mailing Address - Fax:
Practice Address - Street 1:12830 SW 1ST LN
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-3260
Practice Address - Country:US
Practice Address - Phone:352-692-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2014-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT266282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic