MEDICARE: SUNITA RUSE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT27109	FL

General Provider Information

NPI Number	:	1003089889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNITA RUSE PT

Provider Business Mailing Address
First Line	:	2760 CYPRESS HEAD TRL
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-7386
Country	:	US
Telephone Number	:	321-356-3810
Fax Number	:

Provider Business Practice Location Address
First Line	:	7203 ALOMA AVE
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-7101
Country	:	US
Telephone Number	:	321-972-3960
Fax Number	:	321-972-3960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2008
Last Update Date	:	11/06/2013

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