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

Mrs. Carol D Russell, PA-C

Individual provider Physician Assistant · NPI 1336134865

Mrs. Carol D Russell, PA-C is a Physician Assistant in Viera, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Partly verified

Some contact details are missing from the federal record.

Space Coast Volunteers In Medicine 2555 Judge Fran Jamieson Way
Viera, FL 32940
Phone: (321) 639-5813
Fax: (321) 637-7312
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence LL861 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA2709 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA2709 (FL)

Record details

NPI number1336134865
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 12, 2005
Last updated in NPPESJanuary 26, 2024
Certification dateJanuary 26, 2024

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