MEDICARE: LYNDA M ROSS PT

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	225100000X	Physical Therapist	070004440	IL

General Provider Information

NPI Number	:	1326076449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDA M ROSS PT

Provider Business Mailing Address
First Line	:	8808 BAY POINTE DR UNIT B207
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-5342
Country	:	US
Telephone Number	:	630-309-4916
Fax Number	:

Provider Business Practice Location Address
First Line	:	8808 BAY POINTE DR UNIT B207
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-5342
Country	:	US
Telephone Number	:	630-309-4916
Fax Number	:

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	05/02/2016

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