Individual
DR. CLARENCE HENRY RUSSELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3466 LITHIA PINECREST RD, VALRICO, FL 33594-6301
(813) 657-3937
(813) 661-9009
Mailing address
3466 LITHIA PINECREST RD, VALRICO, FL 33594-6301
(813) 657-3937
(813) 661-9009
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC2807
FL
Other
Enumeration date
10/20/2005
Last updated
07/08/2007
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