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General NPI Number Information
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NPI Number | 1386963932
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALTH & SPORTS MEDICINE LLC
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Dates
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Enumeration Date | 05/21/2010
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 201 VILLAGE OAKS DR
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City | FRUIT COVE
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State | FL
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Zip | 32259-3876
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Country | US
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Telephone | 904-240-0442
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Fax | 904-240-0471
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Provider Business Mailing Address
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Address Line | 201 VILLAGE OAKS DR
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City | FRUIT COVE
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State | FL
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Zip | 32259-3876
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Country | US
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Telephone | 904-240-0442
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROSS OSBORN
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Credential | MD
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Telephone | 904-240-0442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME89577
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License Number State | FL
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