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ISABELLA HASSAN DI GRUCCIO
Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1972069219
Individual Registrant: ISABELLA HASSAN DI GRUCCIO
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
10655 S LAGO VISTA CIR PARKLAND, FL 33076-2982 US
Tel: 954-940-0971 Fax: --
Tel: 954-940-0971 Fax: --
Contact information for business:
10655 S LAGO VISTA CIR PARKLAND, FL 33076-2982 US
Tel: 954-940-0971 Fax: --
Tel: 954-940-0971 Fax: --
Registration Information:
NPI: 1972069219
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Athletic Trainer | ||
| Y | 390200000X | Student Organized Health Care Education/Training Program |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
