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1134643315
JACKIE MARIE RUSSO
MIRAMAR, FL
NPI
1134643315
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL ARNP9295134)
Enumeration Date
2017-07-31
Last Update Date
2022-03-02
Business Address
JACKIE MARIE RUSSO NP
12600 PEMBROKE RD STE 310
MIRAMAR, FL 33027-2544
Phone number: 954-431-7681
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Mailing Address
JACKIE MARIE RUSSO NP
12600 PEMBROKE RD STE 310
MIRAMAR, FL 33027-2544
Phone number: 954-431-7681
Copy
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