Doctor Name: | DR. SUSAN J ROSS |
NPI Number: | 1881648152 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | BR8389644 |
Business Practice Address: | 40107 Hwy 27 Davenport, FL - 33837 |
Business Phone Number: | 8634190692 |
Business Fax Number: | 8634191695 |
Mailing Address: | Po Box 90758, LAKELAND |
State: | FL |
Postal Code: | 338040758 |
Phone Number: | 4075669899 |
Fax Number: | 4075669893 |
NPI Enumeration Date: | 05/20/2006 |
NPI Last Update Date: | 06/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | BR8389644 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |