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Individual

MR. JOSEPH WILLIAM RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, CPNP

Contact information

Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-5437
Mailing address
3401 GERBER DAISY LN, OVIEDO, FL 32766-6689
(203) 731-4169

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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