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Organization
RUSS TANNENBAUM DC PA
Active
Organization
RUSS TANNENBAUM DC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY HAWKS (BILLER)
(954) 993-4058
Entity
Organization
Contact information
Practice address
4974 W ATLANTIC BLVD, MARGATE, FL 33063-5300
(954) 968-8400
(954) 388-5937
Mailing address
5800 COLONIAL DRIVE, STE 305, MARGATE, FL 33063
(954) 993-4058
(954) 916-5198
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH4086
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88856
BLUE CROSS FLORIDA
FL
Enumeration date
09/18/2012
Last updated
09/09/2025
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