JUSTIN LEE RUSSELL (NPI# 1710539416) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710539416 |
| Entity Type | Individual |
| Full Name | JUSTIN LEE RUSSELL |
| Credential | PA |
| Practice Address |
11505 Rangeland Pkwy Bradenton FL 34211-4041 |
| Practice Telephone | 9413628662 |
| Practice Fax Number | 9413628602 |
| Mailing Telephone | 9413628662 |
| Mailing Fax Number | 9413628602 |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2020-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003092594 | Justin Jake Russell | Specialist | 22470 Humphrey Dr, Leavenworth, WA 98826-9240 | 2008-01-14 |
| 1841420304 | Justin Russell | Counselor | 6147 Sutter Ave, Carmichael, CA 95608-2738 | 2009-07-19 |
| Street Address |
11505 RANGELAND PKWY |
| City | BRADENTON |
| State | FL |
| Zip Code | 34211-4041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992702799 | Anthony R Hemmer | Family Medicine | 11505 Rangeland Pkwy, Bradenton, FL 34211-9504 | 2005-07-07 |
| 1184271835 | Lindsey Ann Minick | Physical Therapist | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2019-08-19 |
| 1003310103 | Amber Swartz | Nurse Practitioner | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2018-03-22 |
| 1649680562 | Ryan Asterita | Internal Medicine | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2014-04-30 |
| 1952735219 | Mark A. Dreyer | Podiatrist | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2013-08-22 |
| 1902152358 | Alexander L Thacker | Family Medicine | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2012-08-02 |
| 1699082800 | Ian M Walsh | Physical Therapist | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2010-09-09 |
| 1811123680 | Elizabeth Anne Kimsey | Nurse Practitioner | 11505 Rangeland Pkwy, Bradenton, FL 34211-9504 | 2009-06-06 |
| 1295998292 | Fariba M Donovan | Internal Medicine | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2008-07-09 |
| 1093972804 | Robert E. Lee Browning Iv | Surgery | 11505 Rangeland Pkwy, Bradenton, FL 34211-4041 | 2008-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265075261 | Lifestream Family Medicine P.a. | Family Medicine | 1957 Worth Court, Bradenton, FL 34211 | 2019-10-22 |
| 1457992414 | Center for Home Dialysis At Lakewood Ranch LLC | Clinic/Center | 1939 Worth Court, Lakewood Ranch, FL 34211 | 2019-10-01 |
| 1811468143 | Life Pharmacy Inc | Pharmacy | 4144 Lakewood Ranch Blvd, Bradenton, FL 34211 | 2018-12-16 |
| 1326557349 | Fabio Rodriguez | Student in an Organized Health Care Education/Training Program | 5000 Lakewood Ranch Blvd, Bradenton, Fl 34211, Bradenton, FL 34211 | 2017-09-21 |
| 1972906121 | Linda Michelle Sizler | Social Worker | 5460 Lena Road, Suite 103, Bradenton, FL 34211 | 2014-10-02 |
| 1972911147 | Cory Matthew Collier | Optometrist | 5489 Lena Rd, Bradenton, FL 34211 | 2014-07-31 |
| 1184069312 | Cassandra Lucia D'addeo | Marriage & Family Therapist | 5454 Lena Rd Unit 106, Bradenton, FL 34211 | 2013-05-01 |
| 1073764338 | Lyndsey K Nalu | Audiologist | 11041 Gatewood Dr, Lakewood Ranch, FL 34211 | 2008-10-06 |
| 1245412451 | Richard A Saladino | Clinic/Center | 11009 Gatewood Dr, #103, Bradenton, FL 34211 | 2007-11-29 |
| 1568528461 | Yusef Cornel Barnes | Chiropractor | 1859 Lakewood Ranch Blvd, Bradenton, FL 34211 | 2006-12-28 |
| Find all providers in zip 34211 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780648949 | Thomas David Snyder | Physician Assistant | 3322 49th Ave E, Bradenton, FL 34203-3944 | 2006-04-14 |
| 1164946752 | Courtney Johnson | Physician Assistant | 6015 Pointe West Blvd, Bradenton, FL 34209-5525 | 2017-07-26 |
| 1548719065 | Jared Devirgilis | Physician Assistant | 206 2nd St E, Bradenton, FL 34208-1042 | 2016-09-26 |
| 1700122397 | Holly L Stump | Physician Assistant | 6015 Pointe West Blvd, Bradenton, FL 34209-5525 | 2012-12-31 |
| 1174534523 | Kristen F Riley | Physician Assistant | 6015 Pointe West Blvd, Bradenton, FL 34209-5525 | 2006-08-11 |
| 1275596728 | Lisa Ann Blacklidge | Physician Assistant | 206 2nd St E, Bradenton, FL 34208-1042 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
| 1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
| 1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
| 1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
| 1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
| 1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
| 1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
| 1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
| 1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.