Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mides Mae Guadalupe, PT

Individual provider Physical Therapist · NPI 1619631207

Mides Mae Guadalupe, PT is a Physical Therapist in Orange Park, Florida. Licensed in Florida. Registered with an NPI since 2021.

Licensed in
FL
In the registry since
2021
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1700 Wells Rd Ste 22
Orange Park, FL 32073-2374
Phone: (904) 209-4714
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT21313 (FL)

Record details

NPI number1619631207
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedOctober 29, 2021
Last updated in NPPESOctober 29, 2021
Certification dateOctober 28, 2021
Mailing address1700 Wells Rd Ste 22, Orange Park, FL 32073-2374

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