Russell, Angela P

Russell, Angela P is an individual health care provider with primary practice located at 1475 Nw 12Th Ave Box 016960 M851, Miami FL 33136-1002. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family Health. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Russell, Angela P can be contacted via phone (305) 243-7520.

Contact Information

Primary practice address
1475 Nw 12Th Ave Box 016960 M851 Miami FL 33136-1002
Phone: (305) 243-7520
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1082342 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1082342 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family Health 364SF0001X 082342 Florida

Profile Details

NPI number 1902826993
LBN Legal business name Russell, Angela P
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Sep 18th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902826993 NPPES
Florida MEDICAID 3050742-00

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