Basic Information
| Provider Information | |||||||||
| NPI: | 1598492712 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEADOWS | ||||||||
| FirstName: | ROSS | ||||||||
| MiddleName: | EARL | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3090 CARUSO CT STE 20 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328068510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218415236 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10000 W COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | OCOEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347613400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072961000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2022 | ||||||||
| LastUpdateDate: | 08/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 11021239 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.