Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT27109 | FL |
NPI | 1003089889 |
---|---|
Provider Name | Sunita Ruse |
First Address | Oviedo, FL 32765-7386 |
Second Address | Winter Park, FL 32792-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 06/11/2013 |