Individual
DR. ROBYN A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
735 N 6TH AVE, WAUCHULA, FL 33873-2002
(863) 773-3322
(863) 773-6458
Mailing address
21 S LAKE AVE, AVON PARK, FL 33825-3901
(863) 385-7070
(888) 971-4152
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4379
FL
152WP0200X
Pediatric Optometrist
OPC4379
FL
152WV0400X
Vision Therapy Optometrist
OPC4379
FL
Other
Enumeration date
11/16/2009
Last updated
05/02/2019
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