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MR. GUSTAVO VIDAL PT
NPI 1184657298
Specialist in Wake Forest, NC

Active since July 09, 2006
123 CAPCOM AVE STE 2, WAKE FOREST, NC 27587(919) 551-4142(919) 694-6417 Get Directions Write a Review

NPPES record last updated: February 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Gustavo Vidal Pt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GUSTAVO VIDAL PT (NPI 1184657298) is an individual specialist in Wake Forest, North Carolina, licensed in North Carolina (8191) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1184657298
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameMR. GUSTAVO VIDALCredential: PT
Location Address123 CAPCOM AVE STE 2Wake Forest, NC 27587-6517
Mailing Address1333 Litchborough WayWake Forest, NC 27587-3612 · (919) 600-4309 · Fax (919) 694-6417
Phone(919) 551-4142
Fax(919) 694-6417
Sole ProprietorNo
Enumeration DateJuly 9, 2006
Last NPPES UpdateFebruary 19, 2024
NPPES CertifiedFebruary 19, 2024
✔ NPI 1184657298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NC · 8191
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
123 CAPCOM AVE STE 2, Wake Forest, NC 27587
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Other Identifiers 1

Other078M3NC · Bcbs Provider Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRAIG WINKELMANN, DDS, PLLC
Clinic/Center (Dental)
123 CAPCOM AVE STE 2
WAKE FOREST, NC 27587
Wake County (919) 570-9100
JUSTIN J SULLIVAN PT
Specialist
123 CAPCOM AVE STE 2
WAKE FOREST, NC 27587
Wake County (919) 551-4142
JAMIE MICHELE BAFARO PT
Physical Therapist
123 CAPCOM AVE STE 2
WAKE FOREST, NC 27587
Wake County (919) 551-4142

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gustavo Vidal's NPI number?

The NPI number for Gustavo Vidal is 1184657298. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Gustavo Vidal located?

Gustavo Vidal practices at 123 Capcom Ave Ste 2, Wake Forest, NC 27587. The listed phone number is (919) 551-4142.

What is Gustavo Vidal's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

What insurance does Gustavo Vidal accept?

Health plans from Blue Cross and Blue Shield of NC list Gustavo Vidal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gustavo Vidal was last updated on February 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.