Healthcare Provider Details

I. General information

NPI: 1265468268
Provider Name (Legal Business Name): ANN M ROSS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 10/26/2020
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 CREEK STATION DR
PENSACOLA FL
32504-8626
US

IV. Provider business mailing address

5855 CREEK STATION DR
PENSACOLA FL
32504-8626
US

V. Phone/Fax

Practice location:
  • Phone: 850-435-4352
  • Fax: 850-497-6195
Mailing address:
  • Phone: 850-435-4352
  • Fax: 850-497-6195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number033313
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME132398
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: