Provider Demographics
NPI:1861454266
Name:HRUSKA, JOHN STEPHEN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STEPHEN
Last Name:HRUSKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-2320
Mailing Address - Country:US
Mailing Address - Phone:772-335-5300
Mailing Address - Fax:772-878-7602
Practice Address - Street 1:7710 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-2320
Practice Address - Country:US
Practice Address - Phone:772-335-5300
Practice Address - Fax:772-878-7602
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70175207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2108056OtherCIGNA
FL200046299OtherRR MCR
FL74486OtherBCBS
FL5059519OtherAETNA
FL5059519OtherAETNA
FLG10020Medicare UPIN
FL0721200001Medicare NSC
74486BMedicare PIN