| Russinoff Concierge Pa | |
|
1411 N Flagler Dr Ste 6200 West Palm Beach FL 33401-3416 | |
| (561) 820-8580 | |
| (561) 820-8581 |
| Full Name | Russinoff Concierge Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1411 N Flagler Dr Ste 6200, West Palm Beach, Florida |
| Authorized Official Name and Position | Ian Russinoff (OWNER) |
| Authorized Official Contact | 9176924892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russinoff Concierge Pa 1411 N Flagler Dr Ste 6200 West Palm Beach FL 33401-3416 Ph: (561) 820-8580 | Russinoff Concierge Pa 1411 N Flagler Dr Ste 6200 West Palm Beach FL 33401-3416 Ph: (561) 820-8580 |
| NPI Number | 1285478784 |
|---|---|
| Provider Enumeration Date | 06/20/2024 |
| Last Update Date | 06/20/2024 |
| Medicare PECOS PAC ID | 4789117326 |
|---|---|
| Medicare Enrollment ID | O20241104002789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285478784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ian Russinoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477548295 PECOS PAC ID: 1850323569 Enrollment ID: I20050902000012 |
| Provider Name | Garrett L Gaillard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952899510 PECOS PAC ID: 7315294386 Enrollment ID: I20210506000124 |
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