Individual
MS. PATRICIA J RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BC-HIS
Contact information
Practice address
115 N PALAFOX ST, PENSACOLA, FL 32502-4838
(850) 438-4092
(850) 438-4095
Mailing address
115 N PALAFOX ST, PENSACOLA, FL 32502-4838
(850) 438-4092
(850) 438-4095
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
AS 1379
FL
247200000X
Other Technician
AS 1379
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085155800
—
FL
05
—
085429800
—
FL
01
—
161297600
ACS
FL
01
—
J0195
UAW
FL
01
—
T 0094
BCBS
FL
Enumeration date
01/26/2007
Last updated
11/10/2016
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