Provider Demographics
NPI:1497522643
Name:LU, WEILI
Entity Type:Individual
Prefix:
First Name:WEILI
Middle Name:
Last Name:LU
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 1:9225 BAY PLAZA BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4412
Mailing Address - Country:US
Mailing Address - Phone:813-440-4933
Mailing Address - Fax:
Practice Address - Street 1:9225 BAY PLAZA BLVD STE 401
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4412
Practice Address - Country:US
Practice Address - Phone:813-440-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician