Grace Manzo Bacani, PT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

PT13661 Issued in FL

Practice address

249 Moray LN
Winter Park, FL 32792-4122

Phone

(407) 646-7703

Fax

(407) 646-7713

NPI assigned

Jul 19, 2017

Last updated

Jul 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1699298844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 MORAY LN",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924122",
            "telephone_number": "407-646-7703",
            "fax_number": "407-646-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 MORAY LN",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924122",
            "telephone_number": "407-646-7703",
            "fax_number": "407-646-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACANI",
        "first_name": "GRACE",
        "middle_name": "MANZO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-19",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "FL",
            "license": "PT13661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamran Justin Azad, MD
• Misbah Fathima Azmath
• Akyiaa Azula, A.P.
• B & G Spine Group Inc.
• B&R Supply LLC
• Joshua Zachary Bachmann
• Rebecca Lynne Baczuk, MD
• Barbie Badell Rodriguez
• Raul Jose Badillo, M.D.
• Chrisline Badio

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.