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General NPI Number Information
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NPI Number | 1104877729
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Entity Type | Organization
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Legal Business Name | AESTHETIC CENTER FOR COSMETIC & RECONSTRUCTIVE SURGERY, LLP
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 3320 SW 34TH CIR
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City | OCALA
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State | FL
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Zip | 34474-3371
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Country | US
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Telephone | 352-629-8154
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Fax | 352-629-5231
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Provider Business Mailing Address
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Address Line | 3320 SW 34TH CIR
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City | OCALA
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State | FL
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Zip | 34474-3371
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Country | US
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Telephone | 352-629-8154
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Fax | 352-629-5231
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAMES H ROGERS
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Credential | M.D.
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Telephone | 352-629-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State | FL
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