MEDICARE: MR. RUSSELL KLEIN RTT

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
1	2471R0002X	Radiation Therapy Radiologic Technologist

General Provider Information

NPI Number	:	1689004400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUSSELL KLEIN RTT

Provider Business Mailing Address
First Line	:	357 NW 87TH TER
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 IRVING ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20422-0001
Country	:	US
Telephone Number	:	202-745-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2013
Last Update Date	:	11/14/2013

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Directions to “ MR. RUSSELL KLEIN RTT” Practice Location

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