Provider Demographics
NPI:1659007722
Name:RUSSO, DANIEL ARMANDO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ARMANDO
Last Name:RUSSO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 NW 76TH TER
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5029
Mailing Address - Country:US
Mailing Address - Phone:305-542-4890
Mailing Address - Fax:
Practice Address - Street 1:5881 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-4618
Practice Address - Country:US
Practice Address - Phone:954-721-8026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist