Provider Demographics
NPI:1023157500
Name:NOCHIMSON, ROSS D (MD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:D
Last Name:NOCHIMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4994 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5748
Mailing Address - Country:US
Mailing Address - Phone:954-748-9300
Mailing Address - Fax:954-748-8556
Practice Address - Street 1:4994 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5748
Practice Address - Country:US
Practice Address - Phone:954-748-9300
Practice Address - Fax:954-748-8556
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63022Medicare UPIN
FL93817Medicare ID - Type Unspecified