Provider Demographics
NPI:1154484830
Name:FUS, ANTHONY JOHN JR (PT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOHN
Last Name:FUS
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7125 FRUITVILLE RD
Mailing Address - Street 2:#434
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8957
Mailing Address - Country:US
Mailing Address - Phone:941-377-5035
Mailing Address - Fax:
Practice Address - Street 1:836 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7554
Practice Address - Country:US
Practice Address - Phone:941-497-1737
Practice Address - Fax:941-497-7889
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106890Medicare ID - Type Unspecified