Provider Demographics
NPI:1225518111
Name:GROSSO, LUISA F
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:F
Last Name:GROSSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 VINE TREE TRL APT D
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8541
Mailing Address - Country:US
Mailing Address - Phone:561-201-0822
Mailing Address - Fax:
Practice Address - Street 1:1655 PALM BEACH LAKES BLVD STE 600
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2208
Practice Address - Country:US
Practice Address - Phone:772-380-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist