Joseph William Russo, DNP, CPNP
Nurse Practitioner, Pediatrics in Orlando, FL. Individual provider (NPI-1).
NPI number1730786104
StatusActive
Last updated in NPPESNov 2, 2022
Details
- NPI
- 1730786104
- Entity type
- Individual (NPI-1)
- Name
- Mr. Joseph William Russo
- Credential
- DNP, CPNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 7, 2020
- Certification date
- Nov 2, 2022
- Last updated
- Nov 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | APRN11012765 | FL | Yes |
| 2080P0204X | Pediatrics, Pediatric Emergency Medicine | R196579 | MD |
Practice location
601 E Rollins StOrlando, FL 32803-1248
Phone 407-303-5437
Mailing address
3401 Gerber Daisy LnOviedo, FL 32766-6689
Phone 203-731-4169
Other practice locations
22 S Greene St
Baltimore, MD 21201-1590
Baltimore, MD 21201-1590
Phone 203-731-4169
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