MEDICARE: DR. ROSS QUINN OSBORN 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
1	207QS0010X	Sports Medicine (Family Medicine) Physician	ME89577	FL

General Provider Information

NPI Number	:	1528042496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSS QUINN OSBORN M.D.

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	:	904-240-2471

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	:	904-240-2471

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	03/31/2025

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