Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | OS14382 | FL |
NPI | 1023243698 |
---|---|
Provider Name | Jessica Rogers |
First Address | Oxford, FL 34484-2951 |
Second Address | Fort Myers, FL 33912-7130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 04/11/2020 |