Provider Demographics
NPI:1912928268
Name:ROSS, THRO, RUANE M.D.'S PA
Entity Type:Organization
Organization Name:ROSS, THRO, RUANE M.D.'S PA
Other - Org Name:RTR UROLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:941-485-3351
Mailing Address - Street 1:842 SUNSET LAKE BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7551
Mailing Address - Country:US
Mailing Address - Phone:941-485-3351
Mailing Address - Fax:941-485-7677
Practice Address - Street 1:842 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7551
Practice Address - Country:US
Practice Address - Phone:941-485-3351
Practice Address - Fax:941-485-7677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00647Medicare ID - Type UnspecifiedMEDICARE GROUP