Individual
JACQUELINE MARIE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 821-8038
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME162440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118225100
—
FL
01
—
MCLHL
BCBS
FL
Enumeration date
05/11/2017
Last updated
08/11/2023
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