Healthcare Provider Details

I. General information

NPI: 1306982491
Provider Name (Legal Business Name): WILLIAM STEVE GRUSS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N SUNCOAST BLVD
CRYSTAL RIVER FL
34428-6712
US

IV. Provider business mailing address

9741 VINEYARD CT
BOCA RATON FL
33428-4344
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-6560
  • Fax: 352-447-1705
Mailing address:
  • Phone: 561-289-7724
  • Fax: 561-470-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0041671
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number49729
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME41671
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: