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Individual

DR. RUSS TANNENBAUM

Active
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Individual

DR. RUSS TANNENBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC PA

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CH0004086
FL
111N00000X
Chiropractor
Primary
CH4086
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380428300
—
FL
Enumeration date
11/17/2006
Last updated
09/09/2025
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