MEDICARE: BRANDI KATHRYN ROSS-DOUGLAS MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	4301102000	MI
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036-115410	IL
3	207R00000X	Internal Medicine Physician	ME125974	FL
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	55363-20	WI
5	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	01065198	IN
6	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME125974	FL
7	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	74490	AZ
8	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	C146751	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000758229	OTHER	IN	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588779904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI KATHRYN ROSS-DOUGLAS MD

Provider Business Mailing Address
First Line	:	601 E ROLLINS ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-1248
Country	:	US
Telephone Number	:	407-303-7283
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 BROADWAY
Second Line	:
City	:	MERRILLVILLE
State	:	IN
Zip	:	46410-7035
Country	:	US
Telephone Number	:	219-738-3424
Fax Number	:

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

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	04/14/2026

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Directions to “ BRANDI KATHRYN ROSS-DOUGLAS MD” Practice Location

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