Provider Demographics
NPI:1841660495
Name:BOYAZIS-RODGER, ANGELA MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIE
Last Name:BOYAZIS-RODGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 LAUREL MANOR DR
Mailing Address - Street 2:STE 204
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5608
Mailing Address - Country:US
Mailing Address - Phone:352-259-0024
Mailing Address - Fax:352-430-1904
Practice Address - Street 1:1950 LAUREL MANOR DR
Practice Address - Street 2:STE. 204
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5603
Practice Address - Country:US
Practice Address - Phone:352-259-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007149111NS0005X
FLCH11898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician