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General NPI Number Information
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NPI Number | 1528056678
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Entity Type | Individual
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Provider Name | BRUCE J ROGERS MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 4739 NW 53RD AVE #A
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City | GAINESVILLE
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State | FL
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Zip | 32653-4800
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Country | US
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Telephone | 352-371-9847
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Fax | 352-371-9526
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Provider Business Mailing Address
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Address Line | 4739 NW 53RD AVE #A
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City | GAINESVILLE
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State | FL
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Zip | 32653-4800
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Country | US
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Telephone | 352-371-9847
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Fax | 352-371-9526
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | FLME0043684
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License Number State | FL
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