MS. KATHLEEN RUSSO (NPI# 1790784932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790784932 |
| Entity Type | Individual |
| Full Name | MS. KATHLEEN RUSSO |
| Credential | ARNP |
| Practice Address |
700 Medical Blvd Englewood FL 34223-3964 |
| Mailing Address |
Po Box 3492 Placida FL 33946-3492 |
| Practice Telephone | 9414756571 |
| Mailing Telephone | 9416980703 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2018-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | ARNP2918432 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP2918432 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 019998700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2061 Englewood Rd Ste 5, Englewood, FL 342231749 | 9414738881 | 9414750801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427481639 | Kathleen Marie Russo | Specialist | 3 Coale Ave, Staten Island, NY 10314-2926 | 2013-08-12 |
| 1437288339 | Kathleen E. Russo | Social Worker | Jewish Family Services, 655 Westfield Ave., Elizabeth, NJ 07208 | 2007-03-05 |
| 1477691707 | Kathleen G Russo | Speech-Language Pathologist | 25439 Bower Ct, Plainfield, IL 60585-2579 | 2007-02-01 |
| 1487203105 | Kathleen Russo | Counselor | 1125 Centre St, Jamaica Plain, MA 02130-3445 | 2019-09-05 |
| 1285112227 | Kathleen Russo | Behavior Technician | 79 W Alexandrine St, Detroit, MI 48201 | 2018-08-01 |
| 1558452532 | Kathleen F Russo | Dermatology | 129 Woodson St, Salisbury, NC 28144-3255 | 2006-09-27 |
| Street Address |
700 MEDICAL BLVD |
| City | ENGLEWOOD |
| State | FL |
| Zip Code | 34223-3964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124021316 | Englewood Emergency Physicians Pa | Emergency Medicine | 700 Medical Blvd, Englewood, FL 34223-3964 | 2005-05-23 |
| 1720473051 | Ahsan Kamal Md | Internal Medicine | 700 Medical Blvd, Englewood, FL 34223-3964 | 2015-04-03 |
| 1104235589 | Fl-i Medical Services LLC | Physician Assistant | 700 Medical Blvd, Englewood, FL 34223-3964 | 2014-08-11 |
| 1326457888 | Ehra Medical Services of Florida LLC | Physician Assistant | 700 Medical Blvd, Englewood, FL 34223-3964 | 2014-08-10 |
| 1285043117 | Mount Si Emergency Physicians LLC | Emergency Medicine | 700 Medical Blvd, Englewood, FL 34223-3964 | 2014-08-05 |
| 1588073415 | Bluefish Lake Inpatient Services LLC | Internal Medicine | 700 Medical Blvd, Englewood, FL 34223-3964 | 2014-08-05 |
| 1790106128 | Redfish Cove Inpatient Services LLC | Physician Assistant | 700 Medical Blvd, Englewood, FL 34223-3964 | 2014-01-03 |
| 1609213545 | Gulf-to-bay Anesthesiology Associates LLC | Anesthesiology | 700 Medical Blvd, Englewood, FL 34223-3964 | 2013-06-02 |
| 1700130432 | Florida Em-i Medical Services Pa | Physician Assistant | 700 Medical Blvd, Englewood, FL 34223-3964 | 2012-11-02 |
| 1003169996 | Crestside Emergency Physicians, LLC | Emergency Medicine | 700 Medical Blvd, Englewood, FL 34223-3964 | 2012-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180285 | Shelby Katherine Chirillo | Behavior Technician | 2500 Bobcat Center, Suite G, North Port, FL 34223 | 2018-10-16 |
| 1073022885 | Stacey Jo Seitz | Nurse Practitioner | 900 Pine Street, Suite 222, Englewood, FL 34223 | 2017-09-25 |
| 1750823688 | Bernice Cynthia Putnam | Technician | 401 E Langsner St, Englewood, FL 34223 | 2016-11-09 |
| 1003366949 | Tiffany Kristine Lamarca | Nurse Practitioner | 2061 Englewood Rd Ste 5, Englewood, FL 34223 | 2016-10-04 |
| 1336578293 | Lawrence Hale | Dentist | 701 S Indiana Ave Ste A, Englewood, FL 34223 | 2013-11-01 |
| 1730404310 | Michael A Arpasi | Hearing Instrument Specialist | 1720 S Mccall Rd Ste H, Englewood, FL 34223 | 2010-04-07 |
| 1962657452 | Amy J. Culbertson | Nurse Practitioner | 1719 Gale St, Englewood, FL 34223 | 2008-11-25 |
| 1396884433 | Cynthia J Juliao | Audiologist | 1108 Larchmont Dr, Englewood, FL 34223 | 2007-02-05 |
| 1538224092 | Cynthia Kay Davis | Obstetrics & Gynecology | 2061 Englewood Rd Ste 1, Englewood, FL 34223 | 2006-12-26 |
| 1902966146 | Dennis M Jewell Dc Pa | Chiropractor | 579 South Indiana Ave, Suite C, Englewood, FL 34223 | 2006-12-11 |
| Find all providers in zip 34223 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508495821 | Jawana Lynn Watson | Nurse Practitioner | 307 Kristina Lynn Pl, Englewood, OH 45322-2354 | 2020-04-07 |
| 1003449737 | Michelle May Roe | Nurse Practitioner | 21 Oakland St, Englewood, NJ 07631-2112 | 2020-02-21 |
| 1528608197 | Ashley Lynn Thompson | Nurse Practitioner | 885 N Union Rd., Englewood, OH 45322 | 2020-01-13 |
| 1619518453 | Theresa Carol Lee | Nurse Practitioner | 420 Grand Ave Ste 101, Englewood, NJ 07631-4141 | 2019-10-02 |
| 1194373977 | Jane Uloma Ibe | Nurse Practitioner | 4018 Clearstream Way, Englewood, OH 45322-1458 | 2019-08-26 |
| 1932768330 | Laurie Ann Cucco | Nurse Practitioner | 3302 Riverview Ave, Englewood, NJ 07631-8720 | 2019-06-10 |
| 1326522848 | Quynh Doan | Nurse Practitioner | 2828 S Mccall Rd Ste 8, Englewood, FL 34224-9516 | 2018-09-20 |
| 1669998464 | Jennifer Diane Novotny | Nurse Practitioner | 3333 S Bannock St Ste 400, Englewood, CO 80110-2436 | 2017-08-14 |
| 1003366949 | Tiffany Kristine Lamarca | Nurse Practitioner | 2061 Englewood Rd Ste 5, Englewood, FL 34223 | 2016-10-04 |
| 1851844211 | Sm Medical LLC | Nurse Practitioner | 1008 Sunset Dr, Englewood, OH 45322-2253 | 2016-08-02 |
| Find all providers in ENGLEWOOD | ||||
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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.