Emerald Lolita Russell-Nathan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME172692 Issued in FL

Practice address

1000 Waterman Way
Tavares, FL 32778-5266

Phone

(407) 975-0412

NPI assigned

Jul 14, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: erussellnathan630491@adventhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Pediatrics

  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1174257299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266",
            "telephone_number": "407-975-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266",
            "telephone_number": "407-975-0412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 N Orange Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044603",
            "country_code": "US",
            "telephone_number": "321-947-5206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL-NATHAN",
        "first_name": "EMERALD",
        "middle_name": "LOLITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME172692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Roth, MD
• Chad M Rowland, RT(R)(CT)
• Maxine A Ruddock, PH.D.
• Stephanie Nicole Rude, APRN, AGACNP
• Jose Manuel Ruiz Sepulveda, MD
• Antrecia Russell
• Safe Space Sitters, LLC
• Sage Dental of Tavares, PLLC
• Astride Saint-Fleur
• Sule Steve Salami, M.D.

• Pediatrics Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.