Healthcare Provider Details

I. General information

NPI: 1679403240
Provider Name (Legal Business Name): MEGHAN LYNN ROSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 HOLLYWOOD BLVD STE 305
HOLLYWOOD FL
33020-6624
US

IV. Provider business mailing address

2450 HOLLYWOOD BLVD STE 305
HOLLYWOOD FL
33020-6624
US

V. Phone/Fax

Practice location:
  • Phone: 954-295-3324
  • Fax:
Mailing address:
  • Phone: 561-727-5397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11047752
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: