Individual
MR. JOSEPH WILLIAM RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CPNP
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
R196579
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11012765
FL
Other
Enumeration date
10/07/2020
Last updated
11/02/2022
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