MEDICARE: CYNTHIA ROGERS MD PA

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	207N00000X	Dermatology Physician	ME93551	FL

General Provider Information

NPI Number	:	1356549695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYNTHIA ROGERS MD PA

Provider Business Mailing Address
First Line	:	8503 S US HIGHWAY 1 STE 9
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-3346
Country	:	US
Telephone Number	:	772-398-3376
Fax Number	:	772-807-8788

Provider Business Practice Location Address
First Line	:	8503 S US HIGHWAY 1 STE 9
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-3346
Country	:	US
Telephone Number	:	772-398-3376
Fax Number	:	772-807-8788

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CYNTHIA JENKINS ROGERS
Credential	:	MD
Telephone Number	:	772-398-3376

Provider Enumeration Date	:	07/09/2007
Last Update Date	:	07/21/2022

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