Basic Information
| Provider Information | |||||||||
| NPI: | 1265468268 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSS | ||||||||
| FirstName: | ANN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5855 CREEK STATION DR | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325048626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504354352 | ||||||||
| FaxNumber: | 8504976195 | ||||||||
| Practice Location | |||||||||
| Address1: | 5855 CREEK STATION DR | ||||||||
| Address2: | |||||||||
| City: | PENSACOLA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 325048626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504354352 | ||||||||
| FaxNumber: | 8504976195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2006 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 033313 | CT | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | ME132398 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 021349800 | 05 | FL | MEDICAID | P5Z6W | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER | L7425 | 01 | FL | MEDICARE | OTHER |