Individual
MARINA B ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 SKYLINE DR STE 1, LADY LAKE, FL 32159-4592
(352) 431-3940
(352) 431-3173
Mailing address
104 E DIXIE AVE, LEESBURG, FL 34748-6350
(352) 431-3940
(352) 431-3173
Taxonomy
Speciality
Code
Description
License number
State
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
APRN11001032
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11001032
LICENSE
FL
Enumeration date
01/28/2019
Last updated
01/28/2019
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