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General NPI Number Information
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NPI Number | 1134052848
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Entity Type | Individual
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Provider Name | NATALIE ELAINE RUSSO
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Gender | Female
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 4641 N STATE ROAD 7 STE 20
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City | COCONUT CREEK
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State | FL
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Zip | 33073-4379
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Country | US
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Telephone | 954-228-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 1751 NW 94TH AVE
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6080
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Country | US
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Telephone | 407-417-3900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-26-541915
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License Number State | FL
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