Healthcare Provider Details

I. General information

NPI: 1013953165
Provider Name (Legal Business Name): KATHRYN EISERMANN ROGERS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6705 SW 57TH AVE SUITE 318
CORAL GABLES FL
33143-3638
US

IV. Provider business mailing address

6705 SW 57TH AVE SUITE 318
CORAL GABLES FL
33143-3638
US

V. Phone/Fax

Practice location:
  • Phone: 305-665-1623
  • Fax: 305-666-9176
Mailing address:
  • Phone: 305-665-1623
  • Fax: 305-666-9176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. KATHRYN CLAIRE EISERMANN-ROGERS
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 305-665-1623