DAVID RUSSO

LAKELAND, FL
NPI1427072685
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA0002344)
Enumeration Date2006-07-27
Last Update Date2007-07-08
Business Address
-- DAVID RUSSO PA
1324 LAKELAND HILLS BLVD
LAKELAND, FL 33805-4543
Phone number: 863-687-1132
Mailing Address
-- DAVID RUSSO PA
4850 LAKE JULIANA RESERVE
AUBURNDALE, FL 33823-5102
Phone number: 863-987-7128
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