Provider Demographics
NPI:1326449117
Name:ROSS, JEFFREY (RN/ACNP/CNS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:RN/ACNP/CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11708 SPOTTED MARGAY AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-4169
Mailing Address - Country:US
Mailing Address - Phone:626-354-6463
Mailing Address - Fax:209-579-5637
Practice Address - Street 1:14900 SW 30TH ST UNIT 277615
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-7203
Practice Address - Country:US
Practice Address - Phone:386-627-5771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031684363LA2100X
VA0001250803364SE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No364SE0003XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistEmergency