MEDICARE: GABRIELLA ROGERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AP4679	FL

General Provider Information

NPI Number	:	1114808102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLA ROGERS

Provider Business Mailing Address
First Line	:	1145 CHARLES ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-1011
Country	:	US
Telephone Number	:	727-637-1858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 4TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-4411
Country	:	US
Telephone Number	:	727-289-7250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2025
Last Update Date	:	09/08/2025

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