Provider Demographics
NPI:1114938586
Name:ROGERS, ANTHONY G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:G
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 NORTH FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:772-335-7246
Mailing Address - Fax:772-335-7202
Practice Address - Street 1:907 NORTH FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:772-335-7246
Practice Address - Fax:772-335-7202
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP3300X
FLME32034208VP0014X, 208VP0014X
FLME62034207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
10719333OtherCAQH
FL40809Medicare ID - Type UnspecifiedMEDICARE