Duval Russell, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26037 Issued in FL

Practice address

7400 Red Bug Lake Rd FL 32765
Oviedo, FL 32765-7154

Phone

(407) 971-2774

NPI assigned

Mar 22, 2016

Last updated

Mar 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1184086936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 RED BUG LAKE RD FL 32765",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657154",
            "telephone_number": "407-971-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 RED BUG LAKE RD FL 32765",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657154",
            "telephone_number": "407-971-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DUVAL",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rudoni Chiropractic Inc (Rudoni Family Chiropractic Center)
• Michael Mark Rudoni
• Sasha Ruiz, MA
• Yisel Ruiz, APRN
• Abigail Runda
• Christine Claudia Rutayisire, APRN
• Catherine Rutter, LMHC
• RX Development Associates, Inc.
• John Ryder, MD
• S.O.a.R Sport Medicine LLC (Aventus Pain and Spine)

• Physical Therapy Assistant in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.