Individual
MR. MIKE RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
7695 SW ELLIPSE WAY, STUART, FL 34997-7251
(772) 777-8109
(772) 283-0440
Mailing address
19112 DAWNWOOD CT, JUPITER, FL 33458-2485
(561) 972-0390
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RT4809
FL
Other
Enumeration date
06/21/2011
Last updated
12/02/2020
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