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General NPI Number Information
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NPI Number | 1194700823
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Entity Type | Individual
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Provider Name | STEPHEN MARK ROSS MD,PHD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 6150 MANASOTA KEY RD
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City | ENGLEWOOD
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State | FL
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Zip | 34223-9253
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Country | US
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Telephone | 410-571-0350
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Fax | 410-571-7069
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Provider Business Mailing Address
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Address Line | PO BOX 380877
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City | MURDOCK
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State | FL
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Zip | 33938-0877
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Country | US
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Telephone | 941-979-5200
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Fax | 941-979-5201
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | HCC8516
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | PMC1621
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | PMC1664
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | PMC1756
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME75401L
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License Number State | FL
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