Individual
DR. IAN RUSSINOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1411 N FLAGLER DR STE 6200, WEST PALM BEACH, FL 33401-3416
(561) 820-8580
(561) 820-8581
Mailing address
10260 S BARNSLEY DR, PARKLAND, FL 33076-4460
(917) 692-4892
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME 91596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01571
MEDICARE CORE
FL
05
—
271745000
—
FL
Enumeration date
09/19/2005
Last updated
02/13/2023
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