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NPI Code Detail

MEDICARE: DR. RUSSELL ANTHONY GUARDINO DPM

MEDICARE:  DR. RUSSELL ANTHONY GUARDINO  DPM
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
1213E00000XPodiatristPO 1493FL

General Provider Information

NPI Number : 1316941883
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUSSELL ANTHONY GUARDINO DPM
Provider Business Mailing Address
First Line : 601 E SAMPLE RD
Second Line : STE 101
City : POMPANO BEACH
State : FL
Zip : 33064-4443
Country : US
Telephone Number : 954-942-5005
Fax Number :
Provider Business Practice Location Address
First Line : 601 E SAMPLE RD
Second Line : STE 101
City : POMPANO BEACH
State : FL
Zip : 33064-4443
Country : US
Telephone Number : 954-942-5005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2005
Last Update Date : 07/08/2007

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Directions to “ DR. RUSSELL ANTHONY GUARDINO DPM” Practice Location

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