MEDICARE: DR. ROSS FAMILY COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1730078114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. ROSS FAMILY COUNSELING LLC

Provider Business Mailing Address
First Line	:	11971 JAMES BAY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7127
Country	:	US
Telephone Number	:	321-576-5538
Fax Number	:

Provider Business Practice Location Address
First Line	:	11971 JAMES BAY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7127
Country	:	US
Telephone Number	:	321-576-5538
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA R ROSS
Credential	:	NBC-HWC
Telephone Number	:	321-576-5538

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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