Most Relevant Information
Provider Data
| NPI Number: | 1003464306 |
| Provider Name: | HUNTER SULLIVAN RUSS |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/29/2019 |
| Last Updated: | 08/29/2019 |
Provider Practice Location
10570 S FEDERAL HWY STE 200
PORT ST LUCIE
FL
349525606
Practice Location Phone/Fax
| Phone: | 7723809972 |
| Fax: | 7723809976 |
Provider Mailing Location
10570 S FEDERAL HWY STE 200
PORT ST LUCIE
FL
349525606
Provider Mailing Phone/Fax
| Phone: | 7723809972 |
| Fax: | 7723809976 |