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General NPI Number Information
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NPI Number | 1922161629
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Entity Type | Individual
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Provider Name | DEBORAH LOUISE ROGALA ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3231 MC MULLEN BOOTH RD
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City | SAFETY HARBOR
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State | FL
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Zip | 34695
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Country | US
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Telephone | 727-725-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 WINDER TRAIL
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City | GASTONIA
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State | NC
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Zip | 28056
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Country | US
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Telephone |
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Fax |
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | ARNP 1486762
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License Number State | FL
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