Healthcare Provider Details

I. General information

NPI: 1902190838
Provider Name (Legal Business Name): DRS. ELLIS, ROJAS, ROSS & DEBS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2011
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8940 N KENDALL DR STE 201E
MIAMI FL
33176-2149
US

IV. Provider business mailing address

PO BOX 744567
ATLANTA GA
30374-4567
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: KAREN VAUGHN
Title or Position: OFFICER
Credential:
Phone: 404-450-4684