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General NPI Number Information
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NPI Number | 1902179815
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Entity Type | Individual
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Provider Name | MRUNMAYI SAHASRABUDHE PT
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Gender | Female
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 2202 BODRICK CIR
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City | BRANDON
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State | FL
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Zip | 33511-1228
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Country | US
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Telephone | 813-203-5577
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Fax | 813-203-5577
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Provider Business Mailing Address
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Address Line | 13011 SUMMERFIELD SQUARE DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-7402
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Country | US
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Telephone | 813-374-2209
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Fax | 813-374-2211
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 034346
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License Number State | NY
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