MEDICARE: EUGINIE CELESTINA ROSS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9444967	FL
2	163W00000X	Registered Nurse	222701	CT
3	363LA2100X	Acute Care Nurse Practitioner	001445	FL
4	363LA2100X	Acute Care Nurse Practitioner	GAA-NP001445	GA
5	363LA2100X	Acute Care Nurse Practitioner	APRN11010892	FL
6	363LA2100X	Acute Care Nurse Practitioner	12.013847	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APRN11010892	OTHER	FL	STATE OF FLORIDA, DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
2	RN9444967	OTHER	FL	STATE OF FLORIDA, DEPARTMENT OF HEALTH, DIVISION OF MEDICAL QUALITY ASSURANCE
3	APRN13847	OTHER	CT	STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
4	GAANP001445	OTHER	GA	STATE OF GEORGIA BRAD RAFFENSPERGER SECRETARY OF STATE GEORGIA BOARD OF NURSING
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184204018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGINIE CELESTINA ROSS APRN

Provider Business Mailing Address
First Line	:	8410 S ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7906
Country	:	US
Telephone Number	:	689-610-4810
Fax Number	:	689-610-4840

Provider Business Practice Location Address
First Line	:	8410 S ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-7906
Country	:	US
Telephone Number	:	407-978-3295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2021
Last Update Date	:	05/28/2026

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