Provider Demographics
NPI:1770172827
Name:GUIDO, JOSELINETT GABRIELA (PTA)
Entity type:Individual
Prefix:MRS
First Name:JOSELINETT
Middle Name:GABRIELA
Last Name:GUIDO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 N LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-3006
Mailing Address - Country:US
Mailing Address - Phone:786-216-2440
Mailing Address - Fax:
Practice Address - Street 1:11120 N LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3006
Practice Address - Country:US
Practice Address - Phone:786-216-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23744225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant