Provider Demographics
NPI:1760674048
Name:ROSS, MARGARET B (PTA)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:B
Last Name:ROSS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8649 LOVAS TRL
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5327
Mailing Address - Country:US
Mailing Address - Phone:727-376-8489
Mailing Address - Fax:
Practice Address - Street 1:3251 MCMULLEN BOOTH ROAD
Practice Address - Street 2:SPORTS MEDICINE CENTER
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-1098
Practice Address - Country:US
Practice Address - Phone:727-725-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA010791225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant