Organization
LAKE WOMEN FOR WOMEN OB/GYN,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAMIE ROGERS MD (OWNER)
(352) 589-6005
Entity
Organization
Contact information
Practice address
2 N EUSTIS ST, EUSTIS, FL 32726-3408
(352) 589-6005
(352) 484-0189
Mailing address
PO BOX 780, TAVARES, FL 32778-0780
(352) 589-6005
(352) 484-0189
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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