Provider Demographics
NPI:1033346507
Name:ROGER, MARIE RUBBY (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:RUBBY
Last Name:ROGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13455 S MILITARY TRL STE A
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1323
Mailing Address - Country:US
Mailing Address - Phone:561-288-6153
Mailing Address - Fax:561-288-6087
Practice Address - Street 1:13455 S MILITARY TRL STE A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-1323
Practice Address - Country:US
Practice Address - Phone:561-288-6153
Practice Address - Fax:561-288-6087
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10033951207R00000X
FLME119734207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine