Individual
DR. MICHAEL L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7856
(321) 843-6432
Mailing address
1222 S ORANGE AVE, ORLANDO, FL 32806-1215
(321) 841-7856
(321) 843-6432
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39076
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
39076
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME114533
FL
207RP1001X
Pulmonary Disease Physician
39076
NC
207RP1001X
Pulmonary Disease Physician
Primary
ME114533
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008144900
—
FL
01
—
ME114533
MEDICAL LICENSE
FL
Enumeration date
10/01/2006
Last updated
11/14/2016
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