Provider Demographics
NPI:1013446624
Name:ROSS ENDOSCOPY, LLC
Entity Type:Organization
Organization Name:ROSS ENDOSCOPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MSC, CCC-SLP
Authorized Official - Phone:907-347-7860
Mailing Address - Street 1:1214 WATERVIEW CT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2930
Mailing Address - Country:US
Mailing Address - Phone:907-347-7860
Mailing Address - Fax:
Practice Address - Street 1:1214 WATERVIEW CT
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2930
Practice Address - Country:US
Practice Address - Phone:907-347-7860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA13634OtherFLORIDA DEPARTMENT OF HEALTH