Provider Demographics
NPI:1457446544
Name:ROGULA, DAWN MARIE (LM CPM)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:ROGULA
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4941 18 AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-5705
Mailing Address - Country:US
Mailing Address - Phone:239-601-4002
Mailing Address - Fax:239-353-2842
Practice Address - Street 1:2520 DAVIS BLVD
Practice Address - Street 2:STE C
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104
Practice Address - Country:US
Practice Address - Phone:239-601-4002
Practice Address - Fax:239-353-2842
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW74176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife