Individual
ROBERT R ROSS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
842 SUNSET LAKE BLVD, SUITE 403, BUILDING B, VENICE, FL 34292-7551
(941) 485-3351
(941) 485-7677
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0014723
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06797
BCBS FL
FL
01
—
15577301
CITRUS HEALTH
FL
01
—
344467
AVMED
FL
01
—
4271860
AETNA PROVIDER #
FL
01
—
P00466615
RAILROAD MEDICARE
FL
Enumeration date
07/28/2005
Last updated
06/15/2011
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