Provider Demographics
NPI:1710204094
Name:ROGERS, TRAVIS PHILLIP (MD)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:PHILLIP
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 1:410 CELEBRATION PL STE 200
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5432
Mailing Address - Country:US
Mailing Address - Phone:407-303-2248
Mailing Address - Fax:407-303-4632
Practice Address - Street 1:410 CELEBRATION PL STE 200
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5432
Practice Address - Country:US
Practice Address - Phone:407-303-2248
Practice Address - Fax:407-303-4632
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program