Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10033951 | TX |
N | 111NI0900X | Internist | BP10033951 | TX |
N | 207R00000X | Internist | ME119734 | FL |
N | 111NI0900X | Internist | ME119734 | FL |
Y | 207RI0200X | Infectious Disease | ME119734 | FL |
NPI | 1033346507 |
---|---|
Provider Name | Marie Rubby Roger |
First Address | Boca Raton, FL 33496-2658 |
Second Address | Boca Raton, FL 33496-2658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2009 |
Last Update Date | 18/05/2016 |