Individual
MISS DELANEY ANN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2502 W SAINT ISABEL ST, TAMPA, FL 33607-6318
(813) 874-5707
(813) 874-5908
Mailing address
5110 S MANHATTAN AVE UNIT 6301, TAMPA, FL 33611-3462
(860) 877-9470
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115943
FL
Other
Enumeration date
05/31/2022
Last updated
06/01/2022
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