| Doctor Name: | RUSSELL N NUSYNOWITZ |
| NPI Number: | 1588661532 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME78190 |
| Business Practice Address: | 2120 Lakeland Hills Blvd Lakeland, FL - 338052906 |
| Business Phone Number: | 8636882334 |
| Business Fax Number: | 8635771167 |
| Mailing Address: | 621 Estates Pl, LONGWOOD |
| State: | FL |
| Postal Code: | 327792857 |
| Phone Number: | 4074512069 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2005 |
| NPI Last Update Date: | 02/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | ME78190 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |