Individual
MR. RUSSELL MWENGELEKAYI TSHIABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
601 E ROLLINS ST STE 400, ORLANDO, FL 32803-1248
(321) 207-0174
Mailing address
601 E ROLLINS ST STE 400, ORLANDO, FL 32803-1248
(321) 207-0174
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN11008517
FL
Other
Enumeration date
08/20/2020
Last updated
01/27/2021
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