Provider Demographics
NPI:1699939744
Name:STEVEN ROSS CRNFA AND CINDY ROSS CRNA,INC
Entity type:Organization
Organization Name:STEVEN ROSS CRNFA AND CINDY ROSS CRNA,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE FIRST ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:561-386-9454
Mailing Address - Street 1:4225 WELLINGTON SHORES DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8351
Mailing Address - Country:US
Mailing Address - Phone:561-386-9454
Mailing Address - Fax:561-792-4478
Practice Address - Street 1:4225 WELLINGTON SHORES DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8351
Practice Address - Country:US
Practice Address - Phone:561-386-9454
Practice Address - Fax:561-792-4478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1618612163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL310032400Medicaid