Denea, Russell
Denea, Russell is an sole proprietor health care provider with primary practice located at 4102 A1A S , Saint Augustine FL 32080-6942. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Denea, Russell can be contacted via phone (904) 471-1300.Contact Information
Primary practice address
4102 A1A S
Saint Augustine FL 32080-6942
Phone: (904) 471-1300
Fax: (904) 471-1333
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 195944 | New York |
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME121648 | Florida |
Profile Details
NPI number | 1235175977 |
---|---|
LBN Legal business name | Denea, Russell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 21st, 2006 |
Last updated | Mar 17th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1235175977 | NPPES |
New York | Other | 960396 | MVP |
New York | Other | B56MB | MVP |
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