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General NPI Number Information
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NPI Number | 1487110706
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Entity Type | Individual
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Provider Name | LAUREN ROSS APRN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 1124 BAYVIEW DR
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-2505
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Country | US
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Telephone | 954-567-1006
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Fax |
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Provider Business Mailing Address
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Address Line | 6779 NW 62ND TER
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City | PARKLAND
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State | FL
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Zip | 33067-1427
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Country | US
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Telephone | 954-682-7365
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11000406
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License Number State | FL
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