Provider Demographics
NPI:1780852202
Name:MICHAEL J. ROGERS MD
Entity Type:Organization
Organization Name:MICHAEL J. ROGERS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:863-385-7183
Mailing Address - Street 1:727 US 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-2169
Mailing Address - Country:US
Mailing Address - Phone:863-385-7183
Mailing Address - Fax:863-385-0088
Practice Address - Street 1:727 US 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-2169
Practice Address - Country:US
Practice Address - Phone:863-385-7183
Practice Address - Fax:863-385-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058778207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7022Medicare PIN
FLE59551Medicare UPIN