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

Mr. Gustavo Vidal, PT

Individual provider Specialist · NPI 1184657298

Mr. Gustavo Vidal, PT is a Specialist in Wake Forest, North Carolina. Licensed in North Carolina. Registered with an NPI since 2006.

Licensed in
NC
In the registry since
2006
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

123 Capcom Ave Ste 2
Wake Forest, NC 27587-6517
Phone: (919) 551-4142
Fax: (919) 694-6417
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 8191 (NC)

Record details

NPI number1184657298
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJuly 9, 2006
Last updated in NPPESFebruary 19, 2024
Certification dateFebruary 19, 2024
Mailing address1333 Litchborough Way, Wake Forest, NC 27587-3612

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