Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | ME85781 | FL |
NPI | 1073511952 |
---|---|
Provider Name | Timothy W Rogers |
First Address | Ocala, FL 34471-0421 |
Second Address | Ocala, FL 34471-0421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 25/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
266957900 | (05) | FL |
CD4677 | RRMC (GRP) (01) | FL |
H84580 | (02) | |
P00091569 | RRMC (IND) (01) | FL |