MEDICARE: WILLIAM GRUSSI PHYSICAL THERAPIST

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	PT32141	FL

General Provider Information

NPI Number	:	1760985006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM GRUSSI PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	763 TREMONT GREENS LN
Second Line	:
City	:	SUN CITY CENTER
State	:	FL
Zip	:	33573-8040
Country	:	US
Telephone Number	:	203-889-7005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 ASTON GARDENS CT
Second Line	:
City	:	SUN CITY CTR
State	:	FL
Zip	:	33573-3824
Country	:	US
Telephone Number	:	813-642-8950
Fax Number	:

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

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	03/13/2018

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