Provider Demographics
NPI:1720366065
Name:GUINAN, LISA MARIE (OTR)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:GUINAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11210 NW 31ST RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6838
Mailing Address - Country:US
Mailing Address - Phone:352-332-0220
Mailing Address - Fax:352-332-0240
Practice Address - Street 1:11210 NW 31ST RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6838
Practice Address - Country:US
Practice Address - Phone:352-332-0220
Practice Address - Fax:352-332-0240
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist