Healthcare Provider Details

I. General information

NPI: 1477515245
Provider Name (Legal Business Name): DENISE SUSAN GRAUMANN-SECINO MS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E SILVER SPRINGS BLVD SUITE K
OCALA FL
34470
US

IV. Provider business mailing address

7351 SE 2ND AVE
OCALA FL
34480
US

V. Phone/Fax

Practice location:
  • Phone: 352-208-3454
  • Fax:
Mailing address:
  • Phone: 352-237-5477
  • Fax: 352-237-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8879
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: