Provider Demographics
NPI:1821166927
Name:GUADAGNI, MARIA-TERESA G (OTR L, CHT, MA ED)
Entity Type:Individual
Prefix:
First Name:MARIA-TERESA
Middle Name:G
Last Name:GUADAGNI
Suffix:
Gender:F
Credentials:OTR L, CHT, MA ED
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 357279
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7279
Mailing Address - Country:US
Mailing Address - Phone:352-373-7984
Mailing Address - Fax:352-332-3812
Practice Address - Street 1:929 N US HIGHWAY 441
Practice Address - Street 2:SUITE 404
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3001
Practice Address - Country:US
Practice Address - Phone:352-259-0842
Practice Address - Fax:352-430-1272
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAA618ZMedicare PIN