Active NPI
Glenn Walean Jr., DPT
- Physical Therapist
- Winter Park, FL
National Provider Identifier
1386383149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT38027
- Practice address
- 200 N Lakemont Ave
Winter Park, FL 32792-3273 - Phone
- (407) 646-7000
- NPI assigned
- May 31, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT38027 | FL | Primary |
Addresses
Primary practice location
200 N Lakemont Ave
Winter Park, FL 32792-3273
Mailing address
915 Innovation Way Apt 411
Altamonte Springs, FL 32714-1865
Phone (425) 408-3982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT38027 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653955200000",
"number": "1386383149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 INNOVATION WAY APT 411",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327141865",
"telephone_number": "425-408-3982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N LAKEMONT AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327923273",
"telephone_number": "407-646-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALEAN",
"first_name": "GLENN",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-31",
"last_updated": "2022-05-31",
"certification_date": "2022-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT38027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.