Provider Demographics
NPI:1750504932
Name:GULSBY, STEPHEN A (RPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:GULSBY
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 SANTA ROSA DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-5665
Mailing Address - Country:US
Mailing Address - Phone:850-932-4078
Mailing Address - Fax:850-932-8918
Practice Address - Street 1:3408 SANTA ROSA DR
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-5665
Practice Address - Country:US
Practice Address - Phone:850-932-4078
Practice Address - Fax:850-932-8918
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist