Provider Demographics
NPI:1225737612
Name:ROSASS VORTEX
Entity Type:Organization
Organization Name:ROSASS VORTEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-271-7348
Mailing Address - Street 1:2095 HIGHWAY A1A APT 4704
Mailing Address - Street 2:
Mailing Address - City:INDIAN HARBOUR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-1803
Mailing Address - Country:US
Mailing Address - Phone:321-271-7348
Mailing Address - Fax:
Practice Address - Street 1:2095 HIGHWAY A1A APT 4704
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-1803
Practice Address - Country:US
Practice Address - Phone:321-271-7348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty