Provider Demographics
NPI:1043980337
Name:ROGERS, NICOLE L (RRT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2967 BURLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-8131
Mailing Address - Country:US
Mailing Address - Phone:407-616-7283
Mailing Address - Fax:
Practice Address - Street 1:2967 BURLINGTON DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-8131
Practice Address - Country:US
Practice Address - Phone:407-616-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT10121227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered