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NPI Code Detail

MEDICARE: DR. CHARLES ANTHONY ROSS M.D.

MEDICARE: DR. CHARLES ANTHONY ROSS M.D.
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
1207Q00000XFamily Medicine PhysicianME96407FL
2207QS0010XSports Medicine (Family Medicine) PhysicianME 96407FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1132846OTHERFLAMERICAN BOARD OF FAMILY MEDICINE
2ME96407OTHERFLMEDICAL LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437287497
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES ANTHONY ROSS M.D.
Provider Business Mailing Address
First Line : 8727 TEMPLE TERRACE HWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-6700
Country : US
Telephone Number : 813-796-5400
Fax Number : 813-776-0079
Provider Business Practice Location Address
First Line : 8727 TEMPLE TERRACE HWY
Second Line :
City : TEMPLE TERRACE
State : FL
Zip : 33637-6700
Country : US
Telephone Number : 813-796-5400
Fax Number : 813-776-0079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 10/13/2022

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