Basic Information
Provider Information
NPI: 1730302324
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YAO
FirstName: GUO-ZHAO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 27552 SUGAR LOAF DR
Address2:  
City: WESLEY CHAPEL
State: FL
PostalCode: 335438644
CountryCode: US
TelephoneNumber: 8139911603
FaxNumber: 8139728267
Practice Location
Address1: 4225 E FOWLER AVE
Address2:  
City: TAMPA
State: FL
PostalCode: 336172026
CountryCode: US
TelephoneNumber: 8139727100
FaxNumber: 8139728267
Other Information
ProviderEnumerationDate: 04/11/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XME-86352FLY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102XMD-048584GAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102XMD-A80547CAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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