Provider Demographics
NPI:1760985006
Name:GRUSSI, WILLIAM (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GRUSSI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 TREMONT GREENS LN
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-8040
Mailing Address - Country:US
Mailing Address - Phone:203-889-7005
Mailing Address - Fax:
Practice Address - Street 1:1311 ASTON GARDENS CT
Practice Address - Street 2:
Practice Address - City:SUN CITY CTR
Practice Address - State:FL
Practice Address - Zip Code:33573-3824
Practice Address - Country:US
Practice Address - Phone:813-642-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32141225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist