Provider Demographics
NPI:1104907310
Name:WANG, LOUIS HSI (PT)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:HSI
Last Name:WANG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12313 GLENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2605
Mailing Address - Country:US
Mailing Address - Phone:813-230-8590
Mailing Address - Fax:813-874-2522
Practice Address - Street 1:2700 W. MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-874-2500
Practice Address - Fax:813-874-2522
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 11681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5627591OtherFIRST HEALTH
FLP00283233Medicare ID - Type UnspecifiedMEDICARE RAILROAD
FL5627591OtherFIRST HEALTH