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General NPI Number Information
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NPI Number | 1528639317
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Entity Type | Individual
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Provider Name | JENNIFER ROSS COMPTIS MD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 4150 N 108TH AVE STE 142
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City | PHOENIX
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State | AZ
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Zip | 85037-5467
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Country | US
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Telephone | 623-322-1145
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Fax | 623-466-9552
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Provider Business Mailing Address
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Address Line | 165 NW 96TH TER APT 3-305
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6281
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Country | US
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Telephone |
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 20-362
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R81100
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License Number State | AZ
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