MEDICARE: DR. RUSSELL PAUL ROGG A.P. O.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	000283	FL

General Provider Information

NPI Number	:	1033176078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSSELL PAUL ROGG A.P. O.M.D.

Provider Business Mailing Address
First Line	:	20555 OLD CUTLER RD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2455
Country	:	US
Telephone Number	:	305-251-4325
Fax Number	:	305-256-7850

Provider Business Practice Location Address
First Line	:	20555 OLD CUTLER RD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-2455
Country	:	US
Telephone Number	:	305-251-4325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	04/25/2025

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