| Entity Name: | ROSS MEDICAL GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 27 Mar 1969 (56 years ago) |
| Document Number: | 600907 |
| FEI/EIN Number | 591258084 |
| Address: | 8200 SW 117TH AVENUE, SUITE 100, MIAMI, FL, 33183, US |
| Mail Address: | 8200 SW 117TH AVE, SUITE 100, MIAMI, FL, 33183, US |
| ZIP code: | 33183 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508961194 | 2006-09-14 | 2023-04-18 | 8200 SW 117TH AVE, SUITE 100, MIAMI, FL, 331834825, US | 8200 SW 117TH AVE, SUITE 100, MIAMI, FL, 331834825, US | |||||||||||||||||||||||||
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| Phone | +1 305-279-7677 |
| Fax | 3052790977 |
Authorized person
| Name | MRS. ZAIDA ROSS |
| Role | OFFICE MANAGER |
| Phone | 3052797677 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | OS0005757 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 052734300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROSS MICHAEL L | Agent | 8200 SW 117TH AVE, MIAMI, FL, 33183 |
| Name | Role | Address |
|---|---|---|
| ROSS MICHAEL L | Director | 6600 CHAPMAN FIELD DRIVE, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| ROSS MICHAEL L | President | 6600 CHAPMAN FIELD DRIVE, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| Ross Zaida M | Secretary | 8200 SW 117TH AVE, MIAMI, FL, 33183 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08323900183 | ROSS MEDICAL GROUP | EXPIRED | 2008-11-18 | 2013-12-31 | No data | PO BOX 566778, MIAMI, FL, 33256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| NAME CHANGE AMENDMENT | 2022-01-18 | ROSS MEDICAL GROUP, INC. | No data |
| NAME CHANGE AMENDMENT | 1995-03-28 | MICHAEL L. ROSS, D.O., P.A. | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
