Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME53588 | FL |
NPI | 1457391237 |
---|---|
Provider Name | Dr. Lawrence W Rodgers JR. |
First Address | Gainesville, FL 32607-2557 |
Second Address | Gainesville, FL 32607-2557 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 16/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14824 | BCBS FL (01) | FL |
370165400 | (05) | FL |
CN8028 | RAILROAD MEDICARE (01) | FL |
F23675 | (02) | FL |