Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackie Marie Russo, NP

Individual provider Nurse Practitioner · NPI 1134643315

Jackie Marie Russo, NP is a Nurse Practitioner in Miramar, Florida. Qualified in 2016, 10 years ago. Practices with Angelo Ayar MD PA, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
10
Licensed in
FL
In the registry since
2017
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

12600 Pembroke Rd Ste 310
Miramar, FL 33027-2544
Phone: (954) 431-7681
Fax: (954) 431-7682
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7150 W 20th Ave Ste 210, Hialeah, FL 33016-5531 — (305) 828-7504

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence ARNP9295134 (FL)

Record details

NPI number1134643315
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 31, 2017
Last updated in NPPESMarch 2, 2022
Certification dateMarch 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Angelo Ayar Md Pa — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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