Provider Demographics
NPI:1568655421
Name:RUSINOWSKI, JOSEPH W JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:W
Last Name:RUSINOWSKI
Suffix:JR
Gender:M
Credentials:PT
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Mailing Address - Street 1:5450 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE NINE
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4317
Mailing Address - Country:US
Mailing Address - Phone:954-725-9125
Mailing Address - Fax:954-725-9135
Practice Address - Street 1:5450 W HILLSBORO BLVD
Practice Address - Street 2:SUITE NINE
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4317
Practice Address - Country:US
Practice Address - Phone:954-725-9125
Practice Address - Fax:954-725-9135
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-10-03
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Provider Licenses
StateLicense IDTaxonomies
FLPT2586225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY5595ZMedicare PIN