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

Michelle Russo

Individual provider Pediatric Occupational Therapist · NPI 1790546414

Michelle Russo is a Pediatric Occupational Therapist in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2024.

Licensed in
FL
In the registry since
2024

Practice location Address checks out

3650 NW Devane St
Lake City, FL 32055-8730
Phone: (386) 758-1811
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence OT24825 (FL)

Record details

NPI number1790546414
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 19, 2024
Last updated in NPPESJanuary 19, 2024
Certification dateJanuary 19, 2024
Mailing address1388 Bitterberry Dr, Orange Park, FL 32065-5239