Provider Demographics
NPI:1518495688
Name:ROGERS, WHITNEY (OD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 APPALOOSA CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-6865
Mailing Address - Country:US
Mailing Address - Phone:864-205-1930
Mailing Address - Fax:
Practice Address - Street 1:2500 W INTERNATIONAL SPEEDWAY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-8146
Practice Address - Country:US
Practice Address - Phone:386-236-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5383152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist