Russi, Brett Walter

Russi, Brett Walter is an individual health care provider with primary practice located at 601 5Th St S , St Petersburg FL 33701-4804. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Russi, Brett Walter can be contacted via phone (727) 767-4170.

Contact Information

Primary practice address
601 5Th St S St Petersburg FL 33701-4804
Phone: (727) 767-4170
Fax: (727) 767-4346
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X ME148663 Florida

Profile Details

NPI number 1891290185
LBN Legal business name Russi, Brett Walter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2018
Last updated Nov 4th, 2024 - about 2 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 1891290185 NPPES
Florida Other LX4JN BCBS
Florida MEDICAID 115074200 BCBS

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