Provider Demographics
NPI:1013711928
Name:MELLMAN, ROSS TYLER (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:TYLER
Last Name:MELLMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17568 FIELDBROOK CIR E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1564
Mailing Address - Country:US
Mailing Address - Phone:561-702-6124
Mailing Address - Fax:
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:FLORIDA ATLANTIC UNIVERSITY INTERNAL MEDICINE RESIDENCY
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486
Practice Address - Country:US
Practice Address - Phone:561-955-5365
Practice Address - Fax:561-955-3577
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program