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General NPI Number Information
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NPI Number | 1518990159
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Entity Type | Organization
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Legal Business Name | MARK E. ROGERS, O.D.,P.A.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5865 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-4617
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Country | US
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Telephone | 954-234-4239
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Fax |
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Provider Business Mailing Address
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Address Line | 7154 N UNIVERSITY DR STE 103
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City | TAMARAC
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State | FL
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Zip | 33321-2916
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Country | US
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Telephone | 954-234-4239
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK ELIOT ROGERS
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Credential | O.D.
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Telephone | 954-234-4239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OPC3049
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3049
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License Number State | FL
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