DR. AMY SIMON ROSS (NPI# 1659564193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659564193 |
| Entity Type | Individual |
| Full Name | DR. AMY SIMON ROSS |
| Credential | MD |
| Practice Address |
4197 Woodlands Pkwy 2nd Floor Palm Harbor FL 34685-3493 |
| Practice Telephone | 7277863810 |
| Practice Fax Number | 7277863855 |
| Mailing Telephone | 7277863810 |
| Mailing Fax Number | 7277863855 |
| Enumeration Date | 2007-08-18 |
| Last Update Date | 2016-09-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | ME100102 | FL | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
ME100102 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | AK980Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659889020 | Amy Ross | Massage Therapist | 5056 1/2 Mlk Jr Way S, Seattle, WA 98118-1913 | 2018-01-18 |
| 1821482688 | Amy Ross | Behavioral Analyst | 6400 W. Boynton Beach Blvd., Suite #741236, Boynton Beach, FL 33474 | 2015-03-19 |
| 1972896058 | Amy B Ross | Occupational Therapist | 2711 Dover Ln, Albany, GA 31721-1584 | 2011-05-23 |
| 1629100714 | Amy L Ross | Dentist | 111 Christie Dr, Lufkin, TX 75904-5575 | 2007-03-12 |
| 1801494901 | Amy Renee Ross | Social Worker | 501 E 15th St Ste 400a, Edmond, OK 73013-5046 | 2020-10-12 |
| 1598384133 | Amy Ross | Rehabilitation Counselor | 1500 Parkside Dr, Bowling Green, KY 42101-2756 | 2020-04-14 |
| 1699304741 | Amy Ross | Student in an Organized Health Care Education/Training Program | 4001 N 3rd St Ste 290, Phoenix, AZ 85012-2071 | 2020-04-02 |
| 1710433909 | Amy Ross | Nurse Practitioner | 30 E Apple St Ste 5254, Dayton, OH 45409 | 2016-08-29 |
| 1285025338 | Amy R. Ross | Psychologist | 9245 Rainier Ave S, Seattle, WA 98118-5569 | 2015-02-11 |
| 1235560079 | Amy Ross | Developmental Therapist | 6 Southside Rd, Danvers, MA 01923-1409 | 2013-12-04 |
| Street Address |
4197 WOODLANDS PKWY 2ND FLOOR |
| City | PALM HARBOR |
| State | FL |
| Zip Code | 34685-3493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427662444 | Jacquelyn Bliss Katchuk Sexton | Nurse Practitioner | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2020-09-08 |
| 1578059606 | Julie Corinne Bucciarelli | Nurse Practitioner | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2018-07-01 |
| 1720423932 | Alexis B Honigbaum | Dermatology | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-2823 | 2013-05-01 |
| 1598020059 | Brandon Shutty | Dermatology | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2012-07-11 |
| 1063737682 | John C Mavropoulos | Dermatology | 4197 Woodlands Pkwy, Palm Harbor, FL 34685 | 2010-04-07 |
| 1235460528 | Ashlee Eberhardt Kirkland | Physician Assistant | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2010-01-26 |
| 1265763676 | Anna Shaw | Nurse Practitioner | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2010-01-25 |
| 1376773697 | Audrey Friedland Ford | Physician Assistant | 4197 Woodlands Pkwy, Palm Harbor, FL 34685-3493 | 2009-07-21 |
| 1497927016 | Palm Harbor Dermatology Pa | Dermatology | 4197 Woodlands Pkwy, 2nd Floor, Palm Harbor, FL 34685-3493 | 2008-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427663376 | Laura Ashley Birch Williams | Physical Therapy Assistant | 4168 Woodlands Pkwy # A, Palm Harbor, FL 34685 | 2020-09-08 |
| 1356993398 | Gary Barbosa | Podiatrist | 3182 Edgemoore Drive, Palm Harbor, FL 34685 | 2019-07-10 |
| 1093277162 | Raza Zaidi | Student in an Organized Health Care Education/Training Program | 3818 Ambassador Dr, Palm Harbor, FL 34685 | 2019-04-05 |
| 1366965063 | Crestar Labs Fl LLC | Clinical Medical Laboratory | 4714 Ayron Terrace, Palm Harbor, FL 34685 | 2017-07-25 |
| 1497284038 | Jacquelle Davis | Social Worker | 1261 Bay Harbor Dr Apt 201, Palm Harbor, FL 34685 | 2017-06-07 |
| 1649693888 | Marliss Rae Jones | Social Worker | 1107 Mainsail Circle, Palm Harbor, FL 34685 | 2014-01-23 |
| 1427489152 | Best At Home Care LLC | In Home Supportive Care | 1801 East Lake Rd, #3a, Palm Harbor, FL 34685 | 2013-12-05 |
| 1457622292 | Dennis Hamilton | Pharmacist | 3420 East Lake Rd, Palm Harbor, FL 34685 | 2012-01-25 |
| 1275770448 | Amy Beach Harcourt | Physical Therapist | 3488 East Lake Rd, Suite 302, Palm Harbor, FL 34685 | 2009-01-09 |
| 1225223589 | Carolyn Kim Puckett | Physical Therapist | 800 Tarpon Woods Blvd., Suite F1, Palm Harbor, FL 34685 | 2007-09-10 |
| Find all providers in zip 34685 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063737682 | John C Mavropoulos | Dermatology | 4197 Woodlands Pkwy, Palm Harbor, FL 34685 | 2010-04-07 |
| 1164605846 | Roger W. Altman,m.d.pa | Dermatology | 32615 Us 19 N, Suite 1, Palm Harbor, FL 34684-3176 | 2007-12-17 |
| 1003898099 | Roger William Altman | Dermatology | 32615 Us Highway 19 N, Suite 1, Palm Harbor, FL 34684-3176 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827577 | Onspot-fl LLC. | Dermatology | 16461 Domestic Ave, Fort Myers, FL 33912-6008 | 2020-10-08 |
| 1942855150 | International Dermatology Research, Inc. | Dermatology | 8370 W Flagler St Ste 200, Miami, FL 33144-2038 | 2019-08-05 |
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1437517802 | Total Vein and Skin LLC | Dermatology | 10383 Hagen Ranch Road, Ste 100, Boynton Beach, FL 33437-3732 | 2016-02-01 |
| 1861812851 | Anand Haryani | Dermatology | 8745 N Us Highway 1, Sebastian, FL 32958-7524 | 2014-04-17 |
| 1164841797 | Michael Montuno | Dermatology | 38135 Market Sq Ste 108, Zephyrhills, FL 33542-7505 | 2014-04-10 |
| 1861813719 | Hillcrest Dermatology and Plastic Surgery P.a. | Dermatology | 733 Highway 466, Lady Lake, FL 32159-6340 | 2013-12-19 |
| 1922355957 | Florida Medical Specialists | Dermatology | 4351 Cortez Rd W, Suite 101, Bradenton, FL 34210 | 2012-08-09 |
| 1619232501 | Alliant Dermatology Pa | Dermatology | 8620 E County Road 466, The Villages, FL 32162-3670 | 2012-07-07 |
| 1114218328 | Leavitt Medical Assocaittes of Florida Inc | Dermatology | 1426 E Bloomindale Ave, Valrico, FL 33596 | 2011-04-21 |
| Find all providers with the same taxonomy | ||||
| City | PALM HARBOR |
| Zip Code | 34685 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.