Provider Demographics
NPI:1427386325
Name:ROGGIERO, DINO MICHAEL
Entity Type:Individual
Prefix:MR
First Name:DINO
Middle Name:MICHAEL
Last Name:ROGGIERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112576
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0143
Mailing Address - Country:US
Mailing Address - Phone:239-776-6565
Mailing Address - Fax:239-236-1263
Practice Address - Street 1:15 ABBOTT AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-2216
Practice Address - Country:US
Practice Address - Phone:239-455-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0903215172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver