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NPI 1457501983 · Physiological Laboratory · Jupiter, FL
Provider details
- NPI number
- 1457501983
- Entity type
- Organization
- Primary specialty
- Physiological LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Michael Russo, Managing Member(561) 972-0390
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
19112 Dawnwood Ct
Jupiter, FL 33458-2485
Phone: (561) 972-0390
Street-level locationGet directions
Mailing address
19112 Dawnwood Ct
Jupiter, FL 33458-2485
Registry dates
- Enumerated
- 2008-09-20
- Last updated
- 2008-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.