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General NPI Number Information
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NPI Number | 1104006030
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Entity Type | Organization
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Legal Business Name | NAPLES DERMATOLOGY PA
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 4085 TAMIAMI TR N SUITE B203
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City | NAPLES
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State | FL
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Zip | 34103
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Country | US
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Telephone | 239-261-3082
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Fax | 239-261-1035
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Provider Business Mailing Address
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Address Line | 4085 TAMIAMI TR N SUITE B203
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City | NAPLES
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State | FL
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Zip | 34103
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Country | US
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Telephone | 239-261-3082
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Fax | 239-261-1035
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT A ROSS
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Credential | MD
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Telephone | 239-261-3082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME0053679
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME0057073
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License Number State | FL
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