Healthcare Provider Details

I. General information

NPI: 1376083725
Provider Name (Legal Business Name): ROSSI JOHN RAMKISSOON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2017
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SW 73RD ST
SOUTH MIAMI FL
33143-4679
US

IV. Provider business mailing address

8510 NW 3RD LN APT 4
MIAMI FL
33126-3857
US

V. Phone/Fax

Practice location:
  • Phone: 786-662-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9269232
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: