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General NPI Number Information
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NPI Number | 1538140231
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Entity Type | Individual
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Provider Name | ROSS A CLEVENS MD
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 707 W EAU GALLIE BLVD
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City | MELBOURNE
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State | FL
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Zip | 32935-5958
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Country | US
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Telephone | 321-727-3223
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Fax | 321-727-9448
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Provider Business Mailing Address
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Address Line | 707 W EAU GALLIE BLVD
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City | MELBOURNE
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State | FL
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Zip | 32935-5958
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Country | US
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Telephone | 321-727-3223
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Fax | 321-727-9448
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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 | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | ME70285
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License Number State | FL
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