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NPI Code Detail

MEDICARE: DIANNA RUSSO

MEDICARE:   DIANNA  RUSSO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN9570998FL

General Provider Information

NPI Number : 1013863117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANNA RUSSO
Provider Business Mailing Address
First Line : 1007 10TH AVE W
Second Line :
City : PALMETTO
State : FL
Zip : 34221-3723
Country : US
Telephone Number : 912-201-8000
Fax Number :
Provider Business Practice Location Address
First Line : 1007 10TH AVE W
Second Line :
City : PALMETTO
State : FL
Zip : 34221-3723
Country : US
Telephone Number : 912-201-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/20/2026

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Directions to “ DIANNA RUSSO ” Practice Location

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