NPI Index

MRS. CAROL RUSSELL, PA-C

Physician Assistant - Medical

Active Individual
NPI: 1336134865

Practice Address

SPACE COAST VOLUNTEERS IN MEDICINE
2555 JUDGE FRAN JAMIESON WAY
Viera, FL 32940

Phone: (321) 639-5813

Specialties

Specialty Code Primary License
Physician Assistant 363A00000X No PA2709 (FL)
Physician Assistant - Medical 363AM0700X Yes LL861 (FL)

Frequently Asked Questions

NPI 1336134865 is the National Provider Identifier for MRS. CAROL RUSSELL, PA-C, a Physician Assistant - Medical provider located in Viera, FL. This NPI was enumerated on September 12, 2005.
MRS. CAROL RUSSELL, PA-C practices at SPACE COAST VOLUNTEERS IN MEDICINE, 2555 JUDGE FRAN JAMIESON WAY, Viera, FL 32940.

Quick Facts

NPI
1336134865
Type
Individual
Enumerated
Sep 12, 2005
Last Updated
Jan 26, 2024

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