Healthcare Provider Details

I. General information

NPI: 1962322008
Provider Name (Legal Business Name): JUAN GABRIEL ROSS-PERKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6761 W INDIANTOWN RD STE 26
JUPITER FL
33458-4619
US

IV. Provider business mailing address

111 ASBURY WAY UNIT B0111
BOYNTON BEACH FL
33426-5459
US

V. Phone/Fax

Practice location:
  • Phone: 561-918-2418
  • Fax:
Mailing address:
  • Phone: 413-313-9205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT44970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: