Provider Demographics
NPI:1093230427
Name:FRYE, GREGORY SCOTT II (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:FRYE
Suffix:II
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 N RONALD REAGAN BLVD
Mailing Address - Street 2:STE 1060
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-3530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:407-322-8404
Practice Address - Street 1:2100 N RONALD REAGAN BLVD
Practice Address - Street 2:STE 1060
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3530
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:407-322-8404
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015070225100000X
FLPT34554225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist