MEDICARE: MS. CHRISTINA DENICE RODGERS NP-C

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	363LF0000X	Family Nurse Practitioner	ARNP9260124	FL

General Provider Information

NPI Number	:	1508290883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINA DENICE RODGERS NP-C

Provider Business Mailing Address
First Line	:	12609 BRAMFIELD DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7775
Country	:	US
Telephone Number	:	813-316-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	8508 ALAFIA HILLS DR
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33567-3408
Country	:	US
Telephone Number	:	813-650-8600
Fax Number	:

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

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	08/22/2013

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