Provider Demographics
NPI:1306982491
Name:GRUSS, WILLIAM STEVE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEVE
Last Name:GRUSS
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 1:9741 VINEYARD CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-4344
Mailing Address - Country:US
Mailing Address - Phone:561-289-7724
Mailing Address - Fax:561-470-8620
Practice Address - Street 1:6201 N SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-6712
Practice Address - Country:US
Practice Address - Phone:352-795-6560
Practice Address - Fax:352-447-1705
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041671207RC0000X
KY49729207RC0000X
FLME41671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63899Medicare UPIN
FL96559Medicare PIN