MEDICARE: CENTER FOR HEALTH & SPORTS MEDICINE LLC

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	261QP2300X	Primary Care Clinic/Center
2	207Q00000X	Family Medicine Physician	ME89577	FL

General Provider Information

NPI Number	:	1386963932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR HEALTH & SPORTS MEDICINE LLC

Provider Business Mailing Address
First Line	:	201 VILLAGE OAKS DR
Second Line	:
City	:	FRUIT COVE
State	:	FL
Zip	:	32259-3876
Country	:	US
Telephone Number	:	904-240-0442
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 VILLAGE OAKS DR
Second Line	:
City	:	FRUIT COVE
State	:	FL
Zip	:	32259-3876
Country	:	US
Telephone Number	:	904-240-0442
Fax Number	:	904-240-0471

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROSS OSBORN
Credential	:	MD
Telephone Number	:	904-240-0442

Provider Enumeration Date	:	05/21/2010
Last Update Date	:	03/28/2025

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