Organization
NATIONAL COSMETIC LASER CENTER
Active
Other names
National Anesthesia Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK ANDRU ROSS MD (OWNER)
(321) 505-2069
Entity
Organization
Contact information
Practice address
1974 ROCKLEDGE BLVD STE 102, ROCKLEDGE, FL 32955-3723
(321) 639-2404
Mailing address
PO BOX 560977, ROCKLEDGE, FL 32956-0977
(321) 639-2404
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME38787
FL
Other
Enumeration date
08/30/2007
Last updated
11/01/2007
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