Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | PT19988 | FL |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT19988 | FL |
NPI | 1659711265 |
---|---|
Provider Name | Shuman Bruinius |
First Address | Sarasota, FL 34233-5214 |
Second Address | Sarasota, FL 34233-2413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 27/06/2013 |