Individual
MR. SEAN MICHAEL RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
3611 5TH AVE N, ST PETERSBURG, FL 33713-7503
(727) 327-3332
(727) 327-7304
Mailing address
3611 5TH AVE N, ST PETERSBURG, FL 33713-7503
(727) 327-3332
(727) 327-7304
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
POR177
FL
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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