Healthcare Provider Details

I. General information

NPI: 1891970240
Provider Name (Legal Business Name): SHELDON ROSS, D.PM., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10109 W OAKLAND PARK BLVD
SUNRISE FL
33351-6917
US

IV. Provider business mailing address

10109 W OAKLAND PARK BLVD
SUNRISE FL
33351-6917
US

V. Phone/Fax

Practice location:
  • Phone: 954-748-9444
  • Fax: 954-749-8712
Mailing address:
  • Phone: 954-748-9444
  • Fax: 954-749-8712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO1131
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberP01131
License Number StateFL

VIII. Authorized Official

Name: DR. SHELDON ROSS
Title or Position: PRESIDENT
Credential: DPM
Phone: 954-748-9444