| Gustavo F Ros Md Pa | |
|
965 Mar Walt Dr Fort Walton Beach FL 32547-6706 | |
| (850) 863-3199 | |
| (850) 863-3196 |
| Full Name | Gustavo F Ros Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 965 Mar Walt Dr, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Gustavo F Ros (OWNER) |
| Authorized Official Contact | 8508633199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo F Ros Md Pa 965 Mar Walt Dr Fort Walton Beach FL 32547-6706 Ph: (850) 863-3199 | Gustavo F Ros Md Pa 965 Mar Walt Dr Fort Walton Beach FL 32547-6706 Ph: (850) 863-3199 |
| NPI Number | 1548754963 |
|---|---|
| Provider Enumeration Date | 06/19/2018 |
| Last Update Date | 09/13/2023 |
| Medicare PECOS PAC ID | 6305199787 |
|---|---|
| Medicare Enrollment ID | O20181101001012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548754963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gustavo F Ros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912902982 PECOS PAC ID: 0840193520 Enrollment ID: I20040129000982 |
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